Gastric fluid volume and pH after nizatidine in adults undergoing elective surgery: influence of timing and dose.
We conducted a prospective, randomized, double-blind study to investigate the effect of oral nizatidine (150-600 mg), a new potent H2 antagonist, on preoperative gastric fluid pH and volume in adults undergoing elective surgery. One hundred and seventy-five healthy adults (21-68 yr) were randomly allocated to seven treatment groups (n = 25); Placebo was administered at 21:00 and 06:30 the night before and on the day of surgery, respectively (0/0: control); nizatidine 150 mg at 21:00 and placebo at 06:30 (150/0); placebo at 21:00 and nizatidine 150 mg at 06:30 (0/150); nizatidine 150 mg at 21:00 and 06:30 (150/150); nizatidine 300 mg at 21:00 and placebo at 06:30 (300/0); placebo at 21:00 and nizatidine 300 mg at 06:30 (0/300); and nizatidine 300 mg at 21:00 and 06:30 (300/300). Each patient fasted overnight and took the drug and/or placebo with 20 ml water. After induction of anaesthesia, the pH and volume of gastric fluid obtained through an orogastric tube were measured. The mean pH of 0/150, 150/150, 300/0, 0/300, and 300/300 groups was higher than that of the control group (P < 0.05). Gastric volume in these groups was smaller than in the control (P < 0.05). The 150/0 group failed to decrease gastric fluid volume and increase pH. In the 300/0 group, the gastric pH was lower than other regimens which effectively decreased gastric acidity (P < 0.05). The number of patients with a pH < 2.5 and a volume > 0.4 ml.kg-1 in the 0/150, 150/150, 0/300, and 300/300 groups (0%) was less than in the control group (16%) (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Mikawa
K
K
Department of Anaesthesiology, Kobe University School of Medicine, Japan.
Nishina
K
K
Maekawa
N
N
Asano
M
M
Obara
H
H
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D017558:Elective Surgical Procedures; D005215:Fasting; D005260:Female; D005744:Gastric Acid / Q000378:metabolism / Q000502:physiology; D005750:Gastric Juice / Q000187:drug effects* / Q000378:metabolism; D006635:Histamine H2 Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007441:Intubation, Gastrointestinal / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D016567:Nizatidine / Q000008:administration & dosage / Q000627:therapeutic use*; D010919:Placebos; D011446:Prospective Studies
D006635:Histamine H2 Antagonists; D010919:Placebos; D016567:Nizatidine