Skip to main content Accessibility help
×
Home

A comparison of the effects of ranitidine and omeprazole on volume and pH of gastric contents in elective surgical patients

  • B. B. Gouda (a1), A. M. Lydon (a2), A. Badhe (a1) and G. D. Shorten (a2)

Extract

Summary

Background and objective: In cases of aspiration of gastric contents the risk of pneumonitis is dependent on the pH and volume of the gastric contents. Omeprazole and rantidine each decrease gastric volume and increase gastric pH. We evaluated the efficacy of preoperative administration of omeprazole (60 mg) or ranitidine (150 mg) in the prophylaxis of aspiration pneumonitis.

Methods: Data were obtained from 75 elective female surgical patients randomly allocated to one of three groups, who received either omeprazole 60 mg orally, or ranitidine 150 mg orally, or neither, on the evening prior to, and on the morning of, surgery. Gastric volume and pH was measured using blind aspiration.

Results: Both pH <2.5 and volume >25 mL were present in none of the patients in either the ranitidine or omeprazole groups, compared to 15 of 25 control patients (P < 0.0001).

Conclusions: Preoperative oral administration of omeprazole (60 mg) or ranitidine (150 mg) reduced residual gastric content volume and increased pH >2.5, possibly reducing the effects of pulmonary aspiration of gastric contents.

Copyright

Corresponding author

Correspondence to: George Shorten, Department of Anaesthesia and Intensive Care, Cork University Hospital, Wilton, Cork, Ireland. E-mail: shorteng@shb.ie; Tel: +353 21 4546400; Fax: +353 21 4546434

References

Hide All

References

Olsson GL, Hallen B, Hambraeus-Jonzon K. Aspiration during anaesthesia: a computer-aided study of 185 358 anaesthetics. Acta Anaesthesiol Scand 1986; 30: 8492.
Roberts RB, Shirley MA. Reducing the risk of acid aspiration during cesarian section. Anesth Analg 1974; 53: 859868.
James CF, Modell JH, Gibbs CP, Kuck EJ, Ruiz BC. Pulmonary aspiration – effects of volume and pH in the rat. Anesth Analg 1984; 63: 665668.
Chaffe A. Which pH paper? Br J Anaesth 1987; 59: 11891191.
Haavik PE, Soreide E, Hofstad B, Steen PA. Does preoperative anxiety influence gastric fluid volume and acidity? Anesth Analg 1992; 75: 9194.
Taylor G. Acid pulmonary aspiration syndrome after antacids. A case report. Br J Anaesth 1975; 47: 615617.
Raidoo DM, Rocke DA, Brock-Utne JG, Marszalek A, Engelbrecht HE. Critical volume for pulmonary acid aspiration: reappraisal in a primate model. Br J Anaesth 1990; 65: 248250.
Kallar SK, Everett LL. Potential risks and preventive measures for pulmonary aspiration: new concepts in preoperative fasting guidelines. Anesth Analg 1993; 77: 171182.
Engelhardt T, Webster NR. Pulmonary aspiration of gastric contents in anaesthesia. Br J Anaesth 1999; 83: 453460.
Taylor WJ, Champion MC, Barry AW, Hurtig JB. Measuring gastric contents during general anaesthesia: evaluation of blind gastric aspiration. Can J Anaesth 1989; 36: 5154.
Hardy JF, Plourde G, Lebrun M, Cote C, Dubes S, Lepage Y. Determining gastric contents during general anaesthesia: evaluation of two methods. Can J Anaesth 1987; 34: 474477.
Maltby JR, Sutherland AD, Sale JP, Shaffer EA. Preoperative oral fluids: is a five hour fast justified prior to elective surgery? Anesth Analg 1986; 65: 112116.
Manchikanti I, Colliver JA, Marrero TC, Roush JR. Assessment of age-related acid aspiration risk factors in pediatric, adult and geriatric patients. Anesth Analg 1985; 64: 1117.
Dobkin ED, Valcour A, McCloskey CR, et al. Does pH paper accurately reflect gastric pH? Crit Care Med 1990; 18: 985988.
Driscoll DM, Cioffi Jr WG, Molter NC, McManus WF, Mason Jr AD, Pruitt Jr BA. Intragastric pH monitoring. J Burn Rehab 1993; 14: 517524.
Levine RL, Fromm Jr RE, Mojtahedzadeh M, Baghaie AA, Opekun Jr AR. Equivalance of litmus paper and intra-gastric pH probes for intragastric pH monitoring in the intensive care unit. Crit Care Med 1994; 22: 945948.
Wilde MI, McTavish D. Omeprazole. An update of its pharmacology and therapeutic use in acid-related disorders. Drugs 1994; 48: 91132.
Manchikanti L, Kraus JW, Edds SP. Cimetidine and related drugs in anesthesia. Anesth Analg 1982; 61: 595608.
Woodings EP, Dixon GT, Harrison C, Carey P, Richards DA. Ranitidine – a new H2 receptor antagonist. Gut 1980; 21: 187191.
Ewart MC, Yau G, Gin T, Kotur CF, Oh TE. A comparison of the effects of omeprazole and ranitidine on gastric secretion in women undergoing elective caesarean section. Anaesthesia 1990; 45: 527530.
Levack ID, Bowie RA, Braid DP, et al. Comparison of the effect of two dose schedules of oral omeprazole with oral ranitidine on gastric aspirate pH and volume in patients undergoing elective surgery. Br J Anaesth 1996; 76: 567569.
Hansen WE, Bertl S. Inhibition of cholinesterases by ranitidine. Lancet 1983; 1: 235.
Hocking MP, Vogel SB. Physiology of gastric secretion and motility in normal and postgastrectomy (post vagotomy) states. In: Hocking MP, Vogel SB, eds. Woodward's Postgastrectomy Syndromes, 2nd edn. Philadelphia, USA: WB Saunders, 1991: 2946.
Parkman HP, Urbain JL, Knight LC, et al. Effect of gastric acid suppressants on human gastric motility. Gut 1998; 42: 243250.
Amir I, Anwar N, Baraona E, Lieber CS. Ranitidine increases the bioavailability of imbibed alcohol by accelerating gastric emptying. Life Sci 1996; 58: 511518.
Parikh R, Sweetland J, Forster ER, Bedding AW, Farr SJ, Smith JT. Ranitidine bismuth citrate and ranitidine do not affect gastric emptying of a radio-labelled liquid meal. Br J Clin Pharmacol 1994; 38: 577580.
Benini L, Castellani G, Bardelli E, et al. Omeprazole causes delay in gastric emptying of digestible meals. Dig Dis Sci 1996; 41: 469474.
Rasmussen L, Qvist N, Oster-Jorgensen E, Rehfeld JF, Holst JJ, Pedersen SA. A double-blind placebo-controlled study on the effects of omeprazole on gut hormone secretion and gastric emptying rate. Scand J Gastroenterol 1997; 32: 900905.
Moore J, Flynn RJ, Sampaio M, Wilson CM, Gillon KR. Effect of single-dose omeprazole on intragastric acidity and volume during obstetric anaesthesia. Anaesthesia 1989; 44: 559562.
Boulay K, Blanloeil Y, Bourveau M, Geay G, Malinovsky JM. Effects of oral ranitidine, famotidine and omeprazole on gastric volume and pH at induction and recovery from general anaesthesia. Br J Anaesth 1994; 73: 475478.
Bouly A, Nathan N, Feiss P. Comparison of omeprazole with cimetidine for prophylaxis of acid aspiration in elective surgery. Eur J Anaesthesiol 1993; 10: 209213.
Roberts CJ. Clinical pharmacokinetics of ranitidine. Clin Pharmacokinet 1984; 9: 211221.
Richardson P, Hawkey CJ, Stack WA. Pharmacology and rationale for use in gastrointestinal disorders. Drugs 1998; 56: 307335.

Keywords

A comparison of the effects of ranitidine and omeprazole on volume and pH of gastric contents in elective surgical patients

  • B. B. Gouda (a1), A. M. Lydon (a2), A. Badhe (a1) and G. D. Shorten (a2)

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed