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KMID : 0381219810130010087
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Journal of RIMSK
1981 Volume.13 No. 1 p.87 ~ p.91
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Pre-anesthetic Cimetidine Alteration of Gastric Juice pH and Volume
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Abstract
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Aspiration of gastric contents into the tracheobronchial tree is a major cause of anesthesia -related morbidity and mortality. Silent regurgitaion of gastric contents occurs more frequently than is realized even with an endotracheal tube in place.
A pH value of less than 2.5 is generally considered the critical level for the development of pulmonary damage. Therefore, routine antacid prophylaxis has been advocated for all anesthesia.
Cimetidine, a new histamine-2 receptor antagonist, increases gastric pH and decreases gastric volume. This study was designed to investigate the effectiveness of cimetidine in reducing the acidity of stomach contents in 81 elective surgical patients.
The results are as follow:
1. Of 45 patients not given cimetidine, 64.4% had a gastric pH less than 2.5 with a mean pH of 2.11(range; 1.68-5.52).
2. Mean values of gastric volume in cimetidine-treated and control patients were 1.5~25. 0 and 4.0~38.0 ml respectively.
3. Of the patients given intravenous cimetidine 40~60 minutes prior to induction of anesthesia 100% had a gastric pH greated than 2.5 (5.61±1.3) and the injection time was reasonable for the effectiveness.
4. Preoperative intravenous cimetidine is an effective adjunct to good anesthetic technique which will reduce the risk of pulmonary damage in a patient who aspirates while receiving anesthesia.
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