CJA
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text (PDF)
Right arrow Submit a scholarly reply
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by STOCK, J. G. L.
Right arrow Articles by SUTHERLAND, A. D.
Right arrow Search for Related Content
PubMed
Right arrow Articles by STOCK, J. G. L.
Right arrow Articles by SUTHERLAND, A. D.

Canadian Journal of Anesthesia, Vol 32, 463-467, Copyright © 1985 by Canadian Anesthesiologists' Society

The Role of H2 Receptor Antagonist Premedication in Pregnant Day Care Patients

JEREMY G. L. STOCK MB CHB FFARCS1 and A. D. SUTHERLAND MB BS FFARACS1

1 Department of Anaesthesia, Foothills Hospital at the University of Calgary, Alberta, T2N 2T9

correspondence should be addressed to Dr. Sutherland

In a randomised study of 132 pregnant outpatients, the effect on gastric volume and pH of oral premedication with a single dose of an H2 antagonist was investigated. Either cimetidine 400 mg (n = 33), or ranitidine 150 mg (n = 33), were given 90 to 120 minutes before scheduled surgery. Mean pH was significantly higher in cimetidine (5.0) and ranitidine (5.2) groups, and mean volume was significantly lower in cimetidine (13.2 ml) and ranitidine (11.1 ml) groups compared with 66 untreated patients (pH 1.6, volume 22.1 ml). A gastric pH ≤2.5 was found in 97 per cent of unpremedicatedpatients and 35 per cent of these patients also had a gastric volume ≥ 25 ml. Eighty-three per cent of patients received their premedication within 75-200 minutes of surgery. Patients premedicated within that range had a significantly lower incidence of either a gastric pH ≤ 2.5 or a volume ≥ 25 ml (p < 0.01). Both cimetidine and ranitidine significantly reduced the number of patients with these risk factors. Four patients, however, in the cimetidine group had both a pH ≤ 2.5 and a volume ≥ 25 ml. Pharmacological manipulation of the gastric environment does not prevent aspiration and clearly cannot be substituted for careful airway management and vigilance on the part of the anaesthetist. However, premedication of pregnant outpatients with a single, oral dose of an H2 antagonist is a simple, inexpensive, safe and effective way of reducing the risk of a severe aspiration pneumonitis.

Key Words: ANAESTHESIA: outpatient • HISTAMINE H2 RECEPTOR BLOCKERS: cimetidine, ranitidine • PNEUMONIA: aspiration • PREMEDICATION: histamine H2receptor blockers, cimetidine, ranitidine






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1985 by the Canadian Anesthesiologists' Society.