Effects of rabeprazole or famotidine during cardiac surgery on perioperative gastric and esophageal pH readings.
OBJECTIVE
Upper gastrointestinal bleeding, particularly from a stress-induced duodenal ulcer, is an extremely important perioperative complication in cardiovascular surgery.


METHODS
In the present study, 33 patients undergoing elective open heart surgery between July 2000 and February 2001 were allocated to either a famotidine (FAM) or rabeprazole (RPZ) group to examine the perioperative gastric and esophageal pH readings, in conjunction with an investigation into the effect of infection with Helicobacter pylori (HP).


RESULTS
Postoperative upper gastrointestinal bleeding did not occur in either group, and the intraoperative and postoperative mean gastric pH readings, as well as the holding time pH>6, suggested sufficient acid suppression by either drug. Gastric acid secretion was less strongly suppressed in HP-negative patients in the FAM group, but was unaffected by HP infection status in the RPZ group.


CONCLUSIONS
The FAM group and RPZ group revealed a sufficient effect of gastric acid suppression. It was indicated that FAM had an insufficient effect of gastric acid suppression for HP-negative patients.
Gon
Shigeyoshi
S
Department of Cardiovascular Surgery, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan.
Irie
Yoshihito
Y
Takahashi
Morio
M
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000293:Adolescent; D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001562:Benzimidazoles / Q000494:pharmacology* / Q000627:therapeutic use; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D003131:Combined Modality Therapy; D004947:Esophagus / Q000187:drug effects* / Q000503:physiopathology; D015738:Famotidine / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D005744:Gastric Acid / Q000378:metabolism; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000517:prevention & control; D006331:Heart Diseases / Q000188:drug therapy / Q000601:surgery; D016481:Helicobacter Infections / Q000382:microbiology / Q000517:prevention & control; D016480:Helicobacter pylori; D006635:Histamine H2 Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D006863:Hydrogen-Ion Concentration / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D019990:Perioperative Care; D064750:Rabeprazole; D013270:Stomach / Q000187:drug effects* / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D001562:Benzimidazoles; D006635:Histamine H2 Antagonists; D064750:Rabeprazole; D015738:Famotidine; D009853:Omeprazole