Sodium citrate premedication in elective caesarean section patients

Area of Science:

• Anesthesiology
• Obstetrics
• Gastroenterology

Background:

• Elective caesarean sections require careful management of gastric contents to prevent aspiration.
• Antacids are commonly used to increase gastric pH before anesthesia.
• Evaluating the efficacy of different antacids is crucial for patient safety.

Purpose of the Study:

• To compare the efficacy of Gelusil and sodium citrate in increasing gastric pH.
• To assess the impact of these agents on gastric volume.
• To determine the optimal antacid for use in patients undergoing caesarean section.

Main Methods:

• Thirty-three patients undergoing elective caesarean section were studied.
• Twenty patients received 30 ml of Gelusil, and thirteen received 30 ml of 0.15 M sodium citrate.
• Gastric fluid was sampled via an 18 French Salem sump tube after tracheal intubation.

Main Results:

• Mean gastric pH was significantly higher with Gelusil (4.54) compared to sodium citrate (2.29).
• 85% of patients receiving sodium citrate had a low gastric pH (<2.5), versus 35% with Gelusil.
• No significant difference in gastric volume was observed between the two groups.

Conclusions:

• 30 ml of 0.15 M sodium citrate is not a satisfactory alternative to Gelusil for increasing gastric pH.
• Gelusil demonstrates superior efficacy in raising gastric pH in parturients prior to caesarean section.
• These findings support the use of Gelusil for reducing aspiration risk in obstetric anesthesia.