Comparison of cimetidine (Tagamet) with antacid for safety and effectiveness in reducing gastric acidity before elective cesarean section.
One hundred twenty-six parturients for elective cesarean section under general anesthesia were allocated to either a cimetidine or an antacid group in a randomized, double-blind, multicenter trial. The cimetidine-treated group received 300 mg cimetidine orally the evening before the operation and 300 mg intramuscularly between 1 and 3 h preoperatively. The antacid-treated group received 30 ml of Mylanta-II orally on both occasions. Gastric volume, 30 min after induction of anesthesia and 30 min before response to oral commands, was less in the cimetidine-treated group. Gastric pH 30 min after induction was greater in the cimetidine-treated group. The maternal serum level of cimetidine at birth was 1.31 +/- 0.12 micrograms/ml and the umbilical venous level was 0.78 +/- 0.05 micrograms/ml. The neonatal gastric acidity, Apgar scores, and Early Neonatal Neurobehavioral Scale (ENNS) scores were similar in both groups. No maternal or neonatal complication was attributed to treatment.
D000293:Adolescent; D000328:Adult; D000536:Aluminum Hydroxide / Q000009:adverse effects / Q000627:therapeutic use*; D000768:Anesthesia, General; D000773:Anesthesia, Obstetrical; D000863:Antacids / Q000009:adverse effects / Q000627:therapeutic use*; D002585:Cesarean Section; D002927:Cimetidine / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D004338:Drug Combinations / Q000009:adverse effects / Q000627:therapeutic use; D004341:Drug Evaluation; D005260:Female; D005744:Gastric Acid / Q000378:metabolism*; D006146:Guanidines / Q000627:therapeutic use*; D006801:Humans; D008274:Magnesium / Q000627:therapeutic use*; D008276:Magnesium Hydroxide / Q000009:adverse effects / Q000627:therapeutic use*; D011015:Pneumonia, Aspiration / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control; D011247:Pregnancy; D011292:Premedication; D012828:Silicones / Q000627:therapeutic use*; D012841:Simethicone / Q000009:adverse effects / Q000627:therapeutic use*
D000863:Antacids; D004338:Drug Combinations; D006146:Guanidines; D012828:Silicones; C008570:aluminum hydroxide, magnesium hydroxide, simethicone drug combination; D000536:Aluminum Hydroxide; D002927:Cimetidine; D012841:Simethicone; D008274:Magnesium; D008276:Magnesium Hydroxide