Related Experiment Videos
[A comparison of oral- and intramuscular-preoperative administration of ranitidine in children]
1Department of Anesthesiology, Kyoto Prefectural University of Medicine.
Insights
Intramuscular ranitidine effectively reduced stomach acid and volume in children before surgery. However, oral ranitidine six hours preoperatively is recommended due to less patient stress.
Area of Science:
- Pediatric Anesthesiology
- Pharmacology
- Gastroenterology
Background:
- Preoperative fasting guidelines aim to minimize aspiration risk.
- Ranitidine is used to reduce gastric acidity and volume.
- Optimizing ranitidine administration for pediatric patients is crucial.
Purpose of the Study:
- To evaluate the efficacy of oral versus intramuscular ranitidine in pediatric patients.
- To assess the impact of ranitidine on intragastric pH and volume.
- To determine optimal preoperative ranitidine dosing for children.
Main Methods:
- Thirty healthy pediatric patients (2-13 years) were randomized into three groups: control, oral ranitidine, and intramuscular ranitidine.
- Ranitidine was administered 12 hours preoperatively at different doses and routes.
- Intragastric pH, volume, and serum ranitidine concentrations were measured.
Main Results:
- Intramuscular ranitidine significantly increased intragastric pH and reduced gastric volume, with high serum concentrations.
- Oral ranitidine showed non-significant effects on pH and volume, with lower serum concentrations.
- Intramuscular injection, while effective, poses a stress risk for children.
Conclusions:
- Intramuscular ranitidine provides effective gastric acid suppression in children.
- Oral ranitidine at 0.4 mg/kg six hours preoperatively is recommended for pediatric premedication.
- This approach balances efficacy with reduced patient stress and pain.
Abstract:
The effect of preoperative oral and intramuscular ranitidine administration on intragastric pH and volume was evaluated in children. Thirty healthy inpatients whose ages were 2-13 years, were randomly assigned to three groups. Twelve hours before the elective operation apple juice was given to the control group, and apple juice with 0.4 mg.kg-1 ranitidine to the second group (Oral group). For the third group (IM group) an intramuscular injection of 0.1 mg.kg-1 ranitidine was done. Intragastric pH was significantly elevated and gastric volume was also significantly reduced in IM group, and serum ranitidine concentration showed a high level of 359.4 +/- 85.6 ng.dl-1 (mean +/- SD). In oral group ranitidine effect on pH and volume was not significant, and the drug serum concentration was 31.6 +/- 13.3 ng.dl-1 which was slightly lower than the effective level. Though the intramuscular injection guaranteed safer gastric content, a painful injection is stressful for children. With the knowledge of elimination rate of serum ranitidine we recommend oral ranitidine (0.4 mg.kg-1) six hours preoperatively for pediatric premedication.