Sodium citrate pretreatment in elective cesarean section patients

Area of Science:

• Anesthesiology
• Gastroenterology
• Obstetrics

Background:

• Aspiration of gastric contents during anesthesia poses a significant risk to patients.
• Elective cesarean sections require careful preoperative management to minimize aspiration risk.

Purpose of the Study:

• To evaluate the efficacy of sodium citrate in increasing gastric pH prior to elective cesarean section.
• To determine the optimal timing for sodium citrate administration to reduce gastric acidity.

Main Methods:

• Thirty-two healthy parturients were randomized into three groups: no antacid, sodium citrate <60 min preoperatively, and sodium citrate >60 min preoperatively.
• Gastric pH and volume were measured immediately after delivery via nasogastric tube.
• Statistical analysis compared gastric pH and volume across the groups.

Main Results:

• Sodium citrate administered <60 min preoperatively significantly increased gastric pH compared to controls.
• No significant difference in gastric volume was observed between groups.
• The combination of low gastric pH (<2.5) and high gastric volume (>25 ml) was eliminated in the short-interval sodium citrate group.

Conclusions:

• Sodium citrate is an effective antacid when given less than 60 minutes before anesthesia induction.
• Preoperative sodium citrate administration can mitigate the risk of gastric acid aspiration in cesarean section patients.
• Timing of administration is crucial for the efficacy of sodium citrate as an antacid.