Norepinephrine Administration Methods for Treating Upper Gastrointestinal Bleeding

When treating upper gastrointestinal bleeding with norepinephrine, it is typically prepared as an 8% norepinephrine solution. For example, two vials of norepinephrine injection, containing a total of 4mg, are mixed with 50ml of chilled saline and chilled mineral water. This solution can then be administered to the patient orally or via a gastric tube directly into the stomach. If a gastric tube is already in place, it is important to thoroughly aspirate any accumulated blood from the stomach before administering the medication. This ensures that the norepinephrine solution can fully contact the gastric mucosa, promoting vasoconstriction and achieving the desired hemostatic effect.

Recommended Dosing Frequency

The usual administration frequency is every four hours, with each dose ranging between 20–50ml of the prepared norepinephrine solution. This interval allows for consistent therapeutic action while minimizing the risk of systemic absorption and associated side effects. The treatment should be closely monitored by a healthcare professional to ensure both safety and efficacy.

Endoscopic Application of Norepinephrine

Direct Application During Endoscopy

In cases where a bleeding site is identified during endoscopic examination, the 8% norepinephrine solution can be directly sprayed onto the bleeding lesion through the biopsy channel of the endoscope. This method is especially effective when the bleeding site is clearly visualized. Topical application during endoscopy provides targeted vasoconstriction and significantly improves the chances of successful hemostasis. It is often used in combination with other endoscopic hemostatic techniques, such as thermal therapy or sclerotherapy, to enhance overall treatment outcomes.