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Anesth Analg 1979; 58:183-188
© 1979 International Anesthesia Research Society
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Pre-Anesthetic Cimetidine Alteration of Gastric Fluid Volume and pH

Dennis W. Coombs, MD*, Donald Hooper, MD{dagger}, and Theodore Colton, ScD{ddagger}

*Fellow in Critical Care. Received from the Section of Anesthesia, Department of Surgery, Dartmouth-Hitchcock Medical Center, Hanover, New Hampshire 03755 {dagger}Assistant Professor of Clinical Surgery. Received from the Section of Anesthesia, Department of Surgery, Dartmouth-Hitchcock Medical Center, Hanover, New Hampshire 03755 {ddagger}Director of Biostatistical Evaluation and Planning, Norris Cotton Cancer Center, Hanover, New Hampshire 03755. Received from the Section of Anesthesia, Department of Surgery, Dartmouth-Hitchcock Medical Center, Hanover, New Hampshire 03755

Abstract

Gastric volume and pH were studied immediately after induction of anesthesia and endotracheal intubation in 101 elective surgical patients. Of 44 patients not given cimetidine, 82% had a gastric pH less than 2.5 with a mean pH of 1.6; 45% of these patients had a gastric aspirate pH less than 2.5 associated with a volume exceeding 25 ml. In 57 patients premedicated with intravenous cimetidine at variable intervals (15 to 60 minutes) prior to induction of anesthesia, a significant time-dependent increase was noted in gastric pH (p < 0.001) together with a decline in gastric volume (p < 0.0011. Of the patients given intravenous cimetidine (mean 4.5 µg/kg) 45 minutes prior to induction of anesthesia, 90% had a gastric pH greater than 2.5. The increase in gastric pH after cimetidine administration would result in a reduced chemical pulmonary reaction should aspiration occur during induction of anesthesia.

Key Words: PHARMACOLOGY: cimetidine • GASTROINTESTINAL TRACT: gastric pH and volume • ACID-BASE EQUILIBRIUM: gastric pH






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1979 by the International Anesthesia Research Society.