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Effects of ranitidine and metoclopramide on gastric fluid pH and volume in children
S Christensen1, A Farrow-Gillespie, J Lerman
1Department of Anaesthesia, Hospital for Sick Children, Toronto, Ontario, Canada.
Insights
Ranitidine, with or without metoclopramide, significantly increased gastric fluid pH in children before surgery. Gastric fluid volume remained unchanged in this study evaluating pediatric premedication effects.
Area of Science:
- Pediatric Anesthesiology
- Gastrointestinal Pharmacology
- Preoperative Medication Management
Background:
- Gastric acid aspiration during pediatric surgery poses a risk.
- Optimizing gastric fluid pH and volume preoperatively is crucial for patient safety.
- Ranitidine and metoclopramide are commonly used agents to manage gastric contents.
Purpose of the Study:
- To evaluate the impact of ranitidine and metoclopramide on gastric fluid pH and volume in children.
- To compare the effects of individual agents versus combination therapy.
- To assess the efficacy of these premedications in a pediatric surgical setting.
Main Methods:
- Forty healthy children aged 2-8 years were randomly assigned to four groups.
- Groups received either no premedication, metoclopramide, ranitidine, or a combination.
- Gastric fluid pH and volume were measured after tracheal intubation.
Main Results:
- Ranitidine administration, alone or with metoclopramide, significantly elevated gastric fluid pH (P < 0.05).
- No significant alterations in gastric fluid volume were observed across the treatment groups.
- Combination therapy showed a similar pH-increasing effect to ranitidine alone.
Conclusions:
- Ranitidine is effective in increasing gastric fluid pH in pediatric patients undergoing surgery.
- Neither ranitidine nor metoclopramide significantly altered gastric fluid volume in this cohort.
- These findings support the use of ranitidine for optimizing gastric pH in pediatric premedication protocols.
Abstract:
To determine the effects of ranitidine and metoclopramide on gastric fluid in children, 40 healthy children (aged 2-8 yr) were allocated randomly to groups of 10 to receive one of four oral premedications 4 h before surgery: no premedication, metoclopramide 0.1 mg kg-1, ranitidine 2 mg kg-1 and metoclopramide 0.1 mg kg-1 with ranitidine 2 mg kg-1. After tracheal intubation, gastric fluid was aspirated and analysed for pH and total fluid volume. Ranitidine, with or without metoclopramide, increased gastric fluid pH significantly compared with control (P less than 0.05). Gastric fluid volume did not change significantly.