Related Experiment Videos
Effect of preanesthetic intramuscular ranitidine on gastric acidity and volume in children
O Kemmotsu1, M Mizushima, Y Morimoto
1Department of Anesthesiology, Hokkaido University School of Medicine, Sapporo, Japan.
Insights
Preanesthetic intramuscular ranitidine (IM) in children significantly increased gastric fluid pH and decreased volume before anesthesia. This ranitidine premedication may reduce aspiration risk in pediatric surgical patients.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pharmacology
Background:
- Pulmonary aspiration during anesthesia is a significant risk in pediatric patients.
- Optimizing gastric fluid properties (pH and volume) is crucial for preventing aspiration.
Purpose of the Study:
- To assess the efficacy of preanesthetic intramuscular (IM) ranitidine in altering gastric fluid pH and volume in children.
- To determine the optimal dosage for ranitidine's effect on gastric contents.
Main Methods:
- A randomized controlled trial involving 40 children aged 1-10 years undergoing elective surgery.
- Three groups received intramuscular ranitidine (1 mg/kg or 2 mg/kg) or placebo 2 hours before anesthesia induction.
- Gastric fluid pH and volume were measured, along with plasma ranitidine concentrations.
Main Results:
- Ranitidine administration significantly reduced gastric fluid volume compared to controls (p < 0.05).
- Mean gastric fluid pH was significantly higher in ranitidine-treated groups (4.6-6.7) versus controls (2.1; p < 0.05).
- Dose-dependent plasma ranitidine concentrations were observed.
Conclusions:
- Preanesthetic IM ranitidine (1-2 mg/kg) effectively increases gastric pH and decreases volume in children.
- This intervention may serve as a valuable adjunct for premedication in pediatric patients at risk of aspiration.
- Ranitidine offers a potential strategy to enhance anesthetic safety in pediatric surgery.
Study Objective:
To evaluate the effects of preanesthetic administration of intramuscular (IM) ranitidine on pH and volume of gastric contents in children.
Design:
Three randomized treatment groups.
Setting:
Central operating rooms at a university hospital.
Patients:
Forty children age 1 to 10 years undergoing a variety of elective surgical procedures requiring general anesthesia with endotracheal intubation.
Interventions:
IM ranitidine 1 mg/kg (n = 15) or 2 mg/kg (n = 15) was administered 2 hours prior to induction of anesthesia. Ten patients without ranitidine served as the control group. An orogastric tube was inserted into each patient.
Measurements And Main Results:
Gastric fluid pH and volume were measured every hour in the three groups. Plasma ranitidine concentrations were measured in ten patients of the ranitidine-treated groups. The mean volume of gastric fluid at induction of anesthesia was significantly lower in the ranitidine-treated patients (2.4 ml for ranitidine 1 mg/kg, 3.2 ml for ranitidine 2 mg/kg) than in the controls (8.6 ml; p less than 0.05). The mean pH values at induction of anesthesia were significantly higher in the ranitidine-treated patients (4.6 for 1 mg/kg, 6.7 for 2 mg/kg) than in the controls (2.1; p less than 0.05). Dose-dependent plasma ranitidine concentrations were obtained.
Conclusions:
Preanesthetic IM ranitidine 1 to 2 mg/kg resulted in a higher pH and lower volume of gastric fluid at the time of induction and in a higher pH during 3 hours of anesthesia. This therapy may be a useful adjunct to premedication for children who have a greater than normal risk of pulmonary aspiration during anesthesia.