Abstract
We have compared the effect of intravenously administered omeprazole and ranitidine on gastric contents in a double-blind study in 80 consecutive women undergoing emergency Caesarean section. When the decision to perform emergency Caesarean section was made, patients were randomly assigned to receive either ranitidine 50 mg or omeprazole 40 mg intravenously. The volume and pH of the gastric contents were measured immediately after tracheal intubation and again before extubation. The gastric pH was found to be higher after omeprazole than after ranitidine immediately after intubation (5.89 ± 1.46 and 5.21 ± 1.36 respectively) (P < 0.05) and before extubation (5.97 ± 1.38 and 5.32 ± 1.24 respectively) (P < 0.05). However, the gastric volumes were comparable in both the groups. The number of patients with gastric volume > 25 ml and pH < 2.5 were 3 (7.5%) in the ranitidine group and 1 (2.5%) in the omeprazole group after intubation and none in either of the groups before extubation. We conclude that omeprazole 40 mg iv administered at the time of the decision to operate, results in higher gastric pH than ranitidine in obstetric patients undergoing emergency Caesarean section.
Résumé
Une étude à double insu nous a permis de comparer l’effet de l’oméprazole et de la ranitidine sur le contenu gastrique de 80 parturientes subissant une césarienne d’urgence. Au moment de h prise de décision en faveur de la césarienne, les patientes ont été réparties aléatoirement pour recevoir soit de la ranitidine 50 mg, soit de l’oméprazole 40 mg par la voie intraveineuse. Le volume et le pH du contenu gastrique ont été mesurés immédiatement après l’intubation et avant l’extubation. Le pH gastrique était plus élevé après l’oméprazole qu’après la ranitidine immédiatement après l’intubation (respectivement 5,89 ± 1,46 et 5,21 ± 1,36, P < 0,05) et avant l’extubation (respectivement 5,97 ± 1,38 et 5,32 ± 1,24, P < 0,05). Cependant, le volume gastrique était comparable entre les deux groupes. Après l’intubation, le nombre de patientes avec un volume gastrique > 25 ml et un pH <2,5 était de trois (7,5%) dans le groupe ranitidine, et de une (2,5%) dans le groupe omeprazole et d’aucune des deux groupes avant l’extubation. Les auteurs concluent que l’oméprazole 40 mg iv administré au moment de la décision d’opérer procurait un pH gastrique plus élevé que la ranitidine chez des parturientes subissant une césarienne en urgence.
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Tripathi, A., Somwanshi, M., Singh, B. et al. A comparison of intravenous ranitidine and omeprazole on gastric volume and pH in women undergoing emergency Caesarean section. Can J Anaesth 42, 797–800 (1995). https://doi.org/10.1007/BF03011180
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DOI: https://doi.org/10.1007/BF03011180