Tamayo-Illescas AJ, Suárez-Cuenca D, Huerta-Vargas JA, Ruiz-Dangu DG

Language: Spanish
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Page: 612-619
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ABSTRACT

Background: The alcohol withdrawal is the presence of vegetative hyperactivity due to craving or need to drink alcohol by the cessation or reduction of prolonged consume of large amounts of alcohol. The ideal treatment for alcohol withdrawal is based on benzodiazepines, scarce clinical studies and practice guidelines about this topic in literature has caused a great variability in its management, not only among different countries but also among different hospitals and even among different clinicians. Therefore, it is customary for the treatment of alcohol withdrawal syndrome rests on the adoption of therapeutic measures derived from individual clinical experiences or reduced groups. Therefore, this study assess the different forms of administration of benzodiazepines in the control of alcohol withdrawal, making comparison against bowling diazepam, that apparently is the gold standard treatment.
Objetive: To determine the therapeutic afficacy of administration of parenteral growing bolus benzodiazepine vs continuous infusion in the treatment of alcohol abstinence syndrome.
Material and Method: A random prospective study that included 96 patients between 18-50 years old, with diagnosis of alcohol withdrawal at General Hospital Xoco, Mexico City, from July 2013 to November 2015; patients were assigned randomly to one of two modalities of treatment: parenteral diazepam infusion vs bowling, comparing the Clinical Institute Withdrawal Assessment of Alcohol Scale, revised (CIWA-Ar) (CIWA-Ar) initial vs CIWA-Ar after 24 hours and the length of hospital stay. The clinical and demographic characteristics of population were evaluated with U Mann-Whitney and χ² being included 94 men (99%).
Results: Groups were distributed according to treatment: bolus 41.6±9.0, infusion 41.1±12.8, bolus and infusion 40.7±13.4 (p=0.52); consumption time in months was: bolus 3.3±0.59, infusion 2.7±0.47 combined treatment 2.4±0.79; severity of alcohol withdrawal, according to CIWA-Ar was: bolus 17.2±6.9, infusion 15.2±5.4, combined treatment 15.8±5.6, p=0.34; percentage change according to different therapeutic modalities was: bolus 70.7±12.4, infusion 54.2±18.4, combined treatment 69.1±13.4, p‹0.001; days of treatment was: bolus 4.5±1.9, infusion 4.9±2.4, combined treatment 5.0±2.3, p 0.76; hospital stay was: bolus 4.5±1.9, infusion 4.9±2.4, combined treatment 5.0±2.3, p 0.76.
Conclusions: Significant therapeutic differences were associated with the treatment with bolus of diazepam in patients with alcohol withdrawal, but no differences in length of hospital stay were found comparing the use of continuous infusion vs bolus.