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Ranitidine prophylaxis before anaesthesia in early pregnancy.
Anaesthesia and Intensive Care
|February 1, 1985
Summary
Ranitidine, given orally or intravenously, effectively increases gastric pH and reduces stomach volume in patients undergoing pregnancy termination. This helps prevent Mendelson's syndrome, a risk for fasting pregnant patients.
Area of Science:
- Obstetrics and Gynecology
- Anesthesiology
- Pharmacology
Background:
- Fasting pregnant patients undergoing procedures are at risk of Mendelson's syndrome due to acidic gastric contents.
- Mendelson's syndrome, a severe form of aspiration pneumonitis, can occur if gastric contents are aspirated during anesthesia.
Purpose of the Study:
- To evaluate the efficacy of ranitidine and sodium citrate in altering gastric volume and pH before vaginal termination of pregnancy.
- To determine the optimal pre-anesthetic medication for reducing aspiration risk in this patient population.
Main Methods:
- Forty patients were randomized into four groups: no medication, oral sodium citrate, oral ranitidine, or intravenous ranitidine.
- Gastric contents were measured for volume and pH via orogastric tube during the procedure.
Main Results:
- Ranitidine (oral and IV) significantly increased gastric pH and decreased gastric volume compared to the control group.
- Sodium citrate raised gastric pH above 2.5 in 60% of patients.
- The control group had only one patient with a gastric pH greater than 2.5.
Conclusions:
- Ranitidine is highly effective in increasing gastric pH and reducing gastric volume in fasting pregnant patients.
- Ranitidine offers a significant protective measure against Mendelson's syndrome in patients undergoing vaginal termination of pregnancy.
- Both oral and intravenous ranitidine demonstrate efficacy, suggesting flexible administration options.