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Cimetidine - antacid combination as premedication for elective Caesarean section
Canadian Anaesthetists' Society Journal
|November 1, 1983
Summary
For Cesarean sections, a combination of cimetidine and magnesium trisilicate effectively prevents acid aspiration pneumonitis. This regimen significantly reduces risks associated with Mendelson's syndrome.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Acid aspiration pneumonitis is a risk during anesthesia.
- Mendelson's syndrome is a severe form of acid aspiration pneumonitis.
Purpose of the Study:
- To evaluate the efficacy of oral antacids and cimetidine for preventing acid aspiration pneumonitis in elective Cesarean sections.
Main Methods:
- 80 patients undergoing elective Cesarean section were studied.
- Groups received magnesium trisilicate, cimetidine, a combination, or no treatment (control).
- Gastric pH and volume were measured to assess risk for acid aspiration.
Main Results:
- Antacids raised pH but not always gastric volume.
- Cimetidine lowered gastric volume and raised pH, but two patients remained at high risk.
- The cimetidine-antacid combination eliminated high-risk patients for acid aspiration pneumonitis.
Conclusions:
- A combination regimen of cimetidine (400 mg PO 3-4 hours pre-op) followed by magnesium trisilicate (20 ml PO 1 hour pre-op) is most effective for prophylaxis.
- This combination regimen proved most efficacious against Mendelson's syndrome in elective Cesarean sections.
- Non-particulate antacids may be preferable to particulate antacids like magnesium trisilicate.