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Canadian Journal of Anesthesia, Vol 33, 773-779, Copyright © 1986 by Canadian Anesthesiologists' Society

The Effects of Cimetidine and Ranitidine With and Without Metoclopramide On Gastric Volume and pH in Morbidly Obese Patients

A. M. LAM MD FRCPC1, D. M. GRACE MD DPHIL FRCSC1, P. H. MANNINEN MD FRCPC1, and C. DIAMOND BA1

1 Departments of Anaesthesia and Surgery, University Hospital and University of Western Ontario, London, Ontario

Address correspondence to: Dr. A.M. Lam, Department of Anaesthesia, University Hospital, P.O. Box 5339, Postal Station A, London, Ontario N6A 5A5.

The efficacy of preanaesthetic intravenous cimetidine versus ranitidine with and without metoclopramide for acid aspiration prophylaxis was assessed in 60 morbidly obese patients in a double-blind manner. Group 1 patients received cimetidine 300 mg + saline. Group 2 patients received cimetidine 300 mg + metoclopramide 10 mg. Group 3 patients received ranitidine 100 mg + saline. Group 4 patients received ranitidine 100 mg + metoclopramide 10 mg. Gastric fluid was aspirated for analysis of volume and pH following induction of anaesthesia. All four premedication regimens were equally effective in reducing the gastric volume and acidity and the inclusion of metoclopramide had no additive effect. Although statistically not significant, two patients in the cimetidine groups remained at risk (volume > 25 ml and pH < 2.5) while no patients in the ranitidine groups remained so.

Key Words: PHARMACOLOGY: cimetidine, ranitidine, metoclopramide • GASTROINTESTINAL TRACT: gastric pH, gastric volume • COMPLICATIONS: aspiration, obesity






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Copyright © 1986 by the Canadian Anesthesiologists' Society.