Prospective double-blind placebo-controlled randomized trial on the use of ranitidine in preventing postoperative gastroduodenal complications in high-risk neurosurgical patients.
To determine the efficacy of ranitidine in preventing clinically acute overt gastroduodenal (GD) complications (bleeding and/or perforation) after neurosurgery, 101 patients with nontraumatic cerebral disease considered at high risk of developing postoperative GD complications were randomized in a standard double-blind manner to receive either ranitidine (50 mg every 6 hours) or placebo medication preoperatively. Postoperative serial GD endoscopy was used to document the occurrence of complications: an overt symptomatic complication was defined as bleeding requiring blood transfusion and/or surgery. Fifty-two patients received ranitidine and 49 received a placebo preoperatively; 30 developed overt GD bleeding; nine of these received ranitidine and 21 received a placebo. Ranitidine significantly reduced the incidence of bleeding (p < 0.05). Multivariate logistic regression analysis revealed three factors of independent significance in predicting overt GD bleeding: use of a placebo drug, a gastric pH of less than 4, and a high daily volume of gastric output. The authors conclude that ranitidine is useful in preventing postoperative GD complications in high-risk neurosurgical patients.
Chan
K H
KH
Department of Surgery, Queen Mary Hospital, University of Hong Kong.
Lai
E C
EC
Tuen
H
H
Ngan
J H
JH
Mok
F
F
Fan
Y W
YW
Fung
C F
CF
Yu
W C
WC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009422:Nervous System Diseases / Q000601:surgery*; D010438:Peptic Ulcer Hemorrhage / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D011379:Prognosis; D011446:Prospective Studies; D011899:Ranitidine / Q000627:therapeutic use*; D012044:Regression Analysis; D012307:Risk Factors; D013312:Stress, Physiological / Q000503:physiopathology
D011899:Ranitidine