Document Detail

Efficacy of a single 24-hour pre-anesthetic dose of proton pump inhibitors.
MedLine Citation:
PMID:  19486452     Owner:  NLM     Status:  MEDLINE    
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.
Kazuyoshi Hirota; Atsushi Imai; Mihoko Kudo; Hiroshi Hashimoto; Tetsuya Kushikata
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2009-04-06
Journal Detail:
Title:  Journal of gastroenterology and hepatology     Volume:  24     ISSN:  1440-1746     ISO Abbreviation:  J. Gastroenterol. Hepatol.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-08-17     Completed Date:  2009-10-28     Revised Date:  2013-04-16    
Medline Journal Info:
Nlm Unique ID:  8607909     Medline TA:  J Gastroenterol Hepatol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  1244-7     Citation Subset:  IM    
Department of Anesthesiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
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MeSH Terms
2-Pyridinylmethylsulfinylbenzimidazoles / administration & dosage*
Administration, Oral
Drug Administration Schedule
Gastric Acidity Determination
Histamine H2 Antagonists / administration & dosage*
Middle Aged
Piperidines / administration & dosage*
Pneumonia, Aspiration / etiology,  prevention & control*
Preanesthetic Medication*
Proton Pump Inhibitors / administration & dosage*
Respiratory Aspiration / etiology,  prevention & control*
Risk Factors
Treatment Outcome
Urologic Surgical Procedures*
Reg. No./Substance:
0/2-Pyridinylmethylsulfinylbenzimidazoles; 0/Histamine H2 Antagonists; 0/Piperidines; 0/Proton Pump Inhibitors; 103577-45-3/lansoprazole; 32828355LL/rabeprazole; ZUP3LSD0DO/roxatidine acetate

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