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Sodium citrate in paediatric outpatients
J M Henderson1, D G Spence, W N Clarke
1Department of Anaesthesia, Children's Hospital of Eastern Ontario, Ottawa.
Insights
Preoperative administration of sodium citrate effectively increases gastric pH in pediatric patients, potentially reducing aspiration-related complications. This antacid is a safe and effective method for raising gastric pH in children.
Area of Science:
- Anesthesiology
- Pediatric Gastroenterology
Background:
- Aspiration during anesthesia poses significant risks, including morbidity and mortality in pediatric patients.
- Elevating gastric content pH is a strategy to mitigate these risks.
Purpose of the Study:
- To evaluate the efficacy of sodium citrate in increasing gastric content pH in pediatric patients preoperatively.
- To assess the safety and tolerability of sodium citrate in this age group.
Main Methods:
- A prospective study involving 25 pediatric patients (aged 1-14 years) who received sodium citrate (0.4 ml/kg) preoperatively.
- Gastric content pH was measured post-induction of anesthesia.
- Comparison with a control group of 20 pediatric patients (aged 7 months-9 years) who did not receive sodium citrate.
Main Results:
- 23 out of 25 patients receiving sodium citrate achieved a gastric pH > 2.5.
- Only 2 patients in the control group had a gastric pH > 2.5 (p < 0.001).
- Sodium citrate was well-tolerated, with only one child refusing the medication.
Conclusions:
- Sodium citrate is an effective and well-tolerated agent for raising gastric content pH in pediatric patients.
- This intervention may help reduce post-aspiration morbidity and mortality in pediatric surgical patients.
Abstract:
To determine whether the gastric content pH of paediatric patients could be raised in an effort to decrease post-aspiration morbidity and mortality, the antacid sodium citrate (0.4 ml.kg-1) was given preoperatively to 25 patients aged 1 to 14 (6.0 +/- 3.5, mean +/- SD) years. Their gastric content pH was measured following induction of anaesthesia. These values were compared to those obtained from a control group (n = 20) ranging in age from seven months to nine (3.3 +/- 2.7) years. A gastric content pH value of greater than 2.5 was measured in 23 of the 25 patients who received sodium citrate. There were only two patients in the control group with a gastric content pH greater than 2.5, p less than 0.001, Fisher exact test. Only one child refused to take the medication. The administration of sodium citrate appears to be an effective method of raising the gastric content pH in paediatric patients.