title: Cimetadine as a preoperative medication to reduce the complications of aspiration of gastric contents.
abstract: In an effort to decrease gastric residual and acid content prior to operation and thus to decrease the risk of aspiration, a prospective clinical trial comparing three drugs was carried out. Eighty-four patients undergoing elective craniotomy for a space-occupying lesion were studied. Twenty-eight patients were premedicated with the anticholinergic atropine (0.01 mg/kg); 28 patients were administered the anticholinergic glycopyrrolate (0.005 mg/kg); and 28 patients were given three preoperative doses of cimetadine and no anticholinergic. Gastric acidity was elevated above pH 2.5 in 93% of those receiving cimetadine, in comparison to 54% for glycopyrrolate and 29% with atropine. In addition, the stomach was completely dry in 54% following cimetadine, and in only 25% and 11% following glycopyrrolate and atropine. Cimetadine is more effective as a preanesthetic agent than anticholinergic drugs in decreasing gastric residual and acid content, and essentially eliminates the risk of aspiration.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001285:Atropine / Q000627:therapeutic use; D002927:Cimetidine / Q000494:pharmacology / Q000627:therapeutic use*; D003399:Craniotomy; D005260:Female; D005750:Gastric Juice / Q000187:drug effects* / Q000378:metabolism; D006024:Glycopyrrolate / Q000627:therapeutic use; D006146:Guanidines / Q000627:therapeutic use*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000517:prevention & control*; D011292:Premedication
chemical_list: D006146:Guanidines; D001285:Atropine; D002927:Cimetidine; D006024:Glycopyrrolate