Effect of oral liquids and ranitidine on gastric fluid volume and pH in children undergoing outpatient surgery

• Published in: Anesthesiology (Philadelphia) Vol. 71; no. 3; pp. 327 - 330
• Main Authors: SANDHAR, B. K, GORESKY, G. V, MALTBY, J. R, SHAFFER, E. A
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott 01.09.1989
• Subjects: Administration, Oral; Adolescent; Ambulatory Surgical Procedures - methods; Anesthesia; Anesthesia depending on patient's condition; Anesthesia, General; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Beverages; Biological and medical sciences; Child; Child, Preschool; Citrus; Gastric Acidity Determination; Gastric Juice - drug effects; Humans; Hydrogen-Ion Concentration; Infant; Medical sciences; Phenolsulfonphthalein; Preoperative Care - methods; Random Allocation; Ranitidine - administration & dosage; Solutions; Human; Surgery; Oral administration; PH; General anesthesia; Ambulatory; Child; Gastric juice
• ISSN: 0003-3022; 1528-1175
• DOI: 10.1097/00000542-198909000-00001

Eighty-eight children (mean age 5.6 yr, range 1-14 yr) about to undergo elective outpatient surgery were randomly assigned to four groups. All children were given phenolsulfonphthalein (PSP) orally 2-3 h before the scheduled time of surgery as a marker dye to assess gastric emptying. Immediately after receiving PSP they were given: group A--liquids, up to 5 ml/kg + placebo (glucose water 0.2 ml/kg); group B--liquids, up to 5 ml/kg + ranitidine 2 mg/kg in glucose water 0.2 ml/kg; group C--placebo only; group D--ranitidine only. Gastric contents were aspirated after induction of anesthesia. Mean volume (range) in ml/kg of aspirated gastric fluid in each group was: group A--0.34 (0-1.0); group B--0.17 (0.07); group C--0.25 (0-1.1); group D--0.16 (0-0.6). The pH mean (range) value was: group A--1.83 (0.9-3.6); group B--4.76 (2.0-7.7); group C--2.10 (1.2-4.1); group D--3.97 (1.3-7.3). PSP could not be detected in the gastric samples from children in whom the ingestion-sampling interval was more than 2.25 h. In comparison with prolonged starvation, administration of oral liquids without ranitidine 2-3 h preoperatively did not produce a significant increase in mean volume of gastric aspirate, and there was no increase in the number of patients with gastric aspirate greater than 0.4 ml/kg. Administration of ranitidine with or without fluids resulted in a decrease in both volume and acidity of gastric contents.