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Efficacy of a single 24‐hour pre‐anesthetic dose of proton pump inhibitors
Author(s) -
Hirota Kazuyoshi,
Imai Atsushi,
Kudo Mihoko,
Hashimoto Hiroshi,
Kushikata Tetsuya
Publication year - 2009
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2009.05850.x
Subject(s) - medicine , anesthesia , anesthetic
Background and Aim: The H 2 receptor antagonist roxatidine is routinely used as an oral pre‐anesthetic medication in surgical patients at night and 2 h before surgery. In the present study, we have compared the effects of roxatidine, rabeprazole and lansoprazole given singly at night as an alternative to the standard double roxatidine medication. Methods: 120 adult patients undergoing urological surgery were randomly assigned to three groups: roxatidine, rabeprazole and lansoprazole ( n = 40 each). Following induction of anesthesia, gastric fluid was obtained by aspiration using a syringe to measure pH and volume of gastric contents. Results: Gastric volume (14.1 ± 1.9 mL) in the lansoprazole group was significantly larger than that in roxatidine (8.6 ± 1.7 mL) and rabeprazole (7.5 ± 1.1 mL) groups ( P < 0.05). Gastric pH in lansoprazole group (4.10 ± 0.38) was also significantly lower than that in the roxatidine group (5.41 ± 0.31, P < 0.05). The numbers of patients with critical factors for acid aspiration pneumonia (gastric pH < 2.5 or volume > 25 mL) in the lansoprazole group was significantly higher than in the roxatidine group ( P < 0.05). Gastric pH and volume in all groups were constant even in the afternoon. Conclusion: Single rabeprazole (but not lansoperazole) medication may be a suitable alternative to standard roxatidine for prophylaxis of acid aspiration pneumonia.