The effects of pre-operative administration of ranitidine on pH and volume of gastric juice.

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Effects of pre-operative administration of ranitidine on pH and volume of gastric juicewere evaluated in 42 patients undergoing elective surgery under general anesthesia. Allpatients were randomly divided into two groups: placebo group (group P), and ranitidinegroup (group R).Patients in group P received placebo (lactose) and served as controls.Patients in group R received ranitidine 300 mg orally at 9: 00 p.m.on the day before surgeryand 50 mg iv immediately after induction of anesthesia (9: 15a.m.). The pH and volumeof gastric juice were measured during induction of anesthesia and every one hour duringsurgery in both groups by continuous sampling of gastric juice utilizing a low-pressuremethod. Plasma ranitidine levels were measured by high performance liquid chromatographyin 5 patients of group R and compared with those of oral administration alone in 6 patientsand of iv administration alone in 6 patients. The gastric pH just after induction of anesthesiawas lower than 2. 5 in 67% of group P and 4% of group R (P<0.05). The gastric volumeover 25ml was seen in 17% of group P and none of group R. There were significantelevations in gastric pH at induction and 1, 2, 3, 5, and 6 hr following induction ofanesthesia in group R compared with group P. The total volume of gastric juice during 4-5hr surgery were 20 ml in group R and 37 ml in group P respectively (P<0.05). Theplasma ranitidine levels 3 hr after iv administration were 186 ng/ml in group R and 128ng/ml in patients of iv administration group alone (P<0.05), and 78ng/ml in patients oforal administration group alone. It is essential to keep gastric pH over 2.5 and gastricvolume less than 25 ml in order to prevent aspiration pneumonitis during anesthesia.Therefore, our data indicate that pre-operative administration (oral plus intravenous) ofranitidine is sufficiently effective to prevent aspiration pneumonitis related to acidity and volume of gastric juice during anesthesia.

The effects of pre-operative administration of ranitidine on pH and volume of gastric juice.

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