Effect of oral liquids and ranitidine on gastric fluid volume and pH in children undergoing outpatient surgery.
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.
Alberta Children's Hospital, Department of Anesthesia, University of Calgary, Alberta, Canada.
B K
BK
Sandhar
G V
GV
Goresky
J R
JR
Maltby
E A
EA
Shaffer
D000284:Administration, Oral; D000293:Adolescent; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D000768:Anesthesia, General; D001628:Beverages; D002648:Child; D002675:Child, Preschool; D002957:Citrus; D005745:Gastric Acidity Determination; D005750:Gastric Juice / Q000187:drug effects*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D010637:Phenolsulfonphthalein; D011300:Preoperative Care / Q000379:methods*; D011897:Random Allocation; D011899:Ranitidine / Q000008:administration & dosage*; D012996:Solutions
D012996:Solutions; D011899:Ranitidine; D010637:Phenolsulfonphthalein