Drug Investigation

, Volume 6, Issue 4, pp 218–222 | Cite as

An Oral Sodium Citrate-Citric Acid Nonparticulate Buffer

In Vitro Buffering Ability and Potential for Pulmonary Toxicity
  • K. A. Payne
  • S. Wandrag
  • P. Griessel
Original Research Article


A new nonparticulate buffering solution of sodium citrate and citric acid was tested for its in vitro acid buffering abilities and its potential for producing a chemical pneumonitis when instilled down the endotracheal tube of anaesthetised beagle dogs. 25ml of the agent buffered 165ml of 0.1 N hydrochloric acid pH 1.4 to a pH of 3.05. Ten beagle dogs were anaesthetised and had 0.4 ml/kg of the buffering agent instilled down the endotracheal tubes. Thereafter the dogs recovered and two were sacrificed every 24 hours. Arterial blood samples were taken regularly for blood gas analysis. Moderate transient arterial blood gas changes were observed in the first 6 to 12 hours. Pulmonary macroscopic and microscopic examination demonstrated no signs of a chemical pneumonitis.

We conclude that this agent is effective in raising the pH of hydrochloric acid and that it lacks the potential for canine pulmonary toxicity.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Agarwal A, Chari P, Singh H. Fluid deprivation before operation. Anaesthesia 44: 632–634, 1989PubMedCrossRefGoogle Scholar
  2. Cohen SE. Aspiration syndrome in pregnancy. Anesthesiology 51: 375–377, 1979PubMedCrossRefGoogle Scholar
  3. Conklin KA, Ziadlou-Rad F. Buffering capacity of citrate antacids. Anesthesiology 58: 391–392, 1983PubMedCrossRefGoogle Scholar
  4. Coombs DW (Editorial). Aspiration pneumonia prophylaxis. Anesthesia and Analgesia 62: 1055–1058, 1983PubMedCrossRefGoogle Scholar
  5. Eyler SW, Cullen BF, Murphy ME, Welch WP. Antacid aspiration in rabbits. A comparison of Mylanta and Bicitra. Anesthesia and Analgesia 61: 288–292, 1982PubMedCrossRefGoogle Scholar
  6. Gibbs CP, Banner TC. The effectiveness of Bicitra as a preoperative antacid. Anesthesiology 61: 97–99, 1984PubMedGoogle Scholar
  7. Gibbs CP, Hempling RE, Wynne JW, Hood CI. Antacid pulmonary aspiration. Anesthesiology 51: 380–385, 1979PubMedCrossRefGoogle Scholar
  8. Harvey SC. Gastric antacids, miscellaneous drugs for the treatment of peptic ulcers, digestants and bile acids. In Goodman & Gilman (Eds) The pharmacological basis of therapeutics, 7th ed., MacMillan Publishing Co., London, 1985Google Scholar
  9. James CF, Gibbs CP. An evaluation of sodium citrate solutions. Anesthesia and Analgesia 62: 241, 1983PubMedCrossRefGoogle Scholar
  10. James CF, Modell JH, Gibbs CP, Kuck J, Ruiz BC. Pulmonary aspiration — effects of volume and pH in the rat. Anesthesia and Analgesia 63: 665–668, 1984PubMedGoogle Scholar
  11. Kennedy TP, Johnson KJ, Kunkel RG, Ward PA, Knight PR, et al. Acute acid aspiration lung injury in the rat. Anesthesia and Analgesia 69: 87–92, 1989PubMedGoogle Scholar
  12. Lahiri SK, Thomas TA, Hodgson RM. Single-dose antacid therapy for the prevention of Mendelson’s syndrome. British Journal of Anaesthesia 45: 1143–1146, 1973PubMedCrossRefGoogle Scholar
  13. Lewis RT, Burgess JH, Hampson LC. Cardiorespiratory studies in critical illness. Changes in aspiration pneumonia. Archives of Surgery 103: 335–340, 1971PubMedCrossRefGoogle Scholar
  14. McGrady EM, MacDonald AG. Effect of the pre-operative administration of water on gastric volume and pH. British Journal of Anaesthesia 60: 803–805, 1988PubMedCrossRefGoogle Scholar
  15. Morgan M. Getting there (editorial). Anaesthesia 46: 709–711, 1991PubMedCrossRefGoogle Scholar
  16. Ormezzano X, Francois T, Viaud J, Bukowski J. Aspiration pneumonitis prophylaxis in obstetric anaesthesia. British Journal of Anaesthesia 64: 503–506, 1990PubMedCrossRefGoogle Scholar
  17. Raidoo DM, Rocke DA, Brock-Utne JG, Marszalek A, Engelbrecht HE. Critical volume for pulmonary acid aspiration. Reappraisal in a primate model. British Journal of Anaesthesia 65: 248–250, 1990PubMedCrossRefGoogle Scholar

Copyright information

© Adis International Limited 1993

Authors and Affiliations

  • K. A. Payne
    • 1
  • S. Wandrag
    • 1
  • P. Griessel
    • 1
  1. 1.University of Stellenbosch Medical SchoolTygerbergSouth Africa

Personalised recommendations