INTRODUCTION: Acute, severe dyspeptic pain is a common condition in the 
emergency department. Despite the traditional "GI cocktail" (GI indicates 
gastrointestinal), an intravenous (IV) proton pump inhibitor (PPI), a novel 
acid-lowering drug, has recently been used to treat this condition. The aim of 
this study was to evaluate the immediate effect of IV pantoprazole in addition 
to the conventional GI cocktail in the relief of severe dyspeptic pain.
METHODS: This double-blind, randomized, controlled study was conducted in the 
emergency department of an urban tertiary-care hospital from January 2011 to 
October 2011. Selected patients with severe dyspeptic pain were randomized to 
treatment with a placebo, antacid, and antispasmodic (conventional group) or IV 
pantoprazole, antacid, and antispasmodic (pantoprazole group). The self-reported 
100-mm visual analog scale score, adverse effects, and overall satisfaction were 
evaluated in 15-minute intervals for 60 minutes.
RESULTS: Eighty-seven eligible cases were enrolled in the study. Forty-four and 
43 patients were randomized in the conventional group and pantoprazole group, 
respectively. There was no difference in the mean 60-minute visual analog scale 
scores between the treatment groups. The rate of "responders," additional drug 
use, adverse effects, and patient satisfaction were similar between the groups.
CONCLUSION: Intravenous PPI provides no additional benefit over the conventional 
GI cocktail in the relief of acute, severe dyspeptic pain. Because of its 
neutral effect and higher cost, the use of IV PPI to treat such conditions 
should be discouraged in general clinical practice.