Effect of preoperative oral erythromycin, erythromycin-ranitidine, and ranitidine-metoclopramide on gastric fluid pH and volume.
OBJECTIVE
To determine whether combining erythromycin with ranitidine is more efficacious than erythromycin or established ranitidine-metoclopramide combination in reducing the volume and acidity of gastric aspirate.


METHODS
Randomized, double-blind study.


METHODS
Operating room complex.


METHODS
Eighty ASA physical status I and II patients.


METHODS
Patients were divided into 4 groups of 20 patients each. All patients received the study medication (in tablet form) packed in identical gelatin capsules 60 to 90 minutes before surgery in the premedication room. Patients in group PP were given two placebo tablets; group EP received erythromycin 250 mg, and placebo; group ER received erythromycin 250 mg, and ranitidine 150 mg; and group RM was given ranitidine 150 mg, and metoclopramide 10 mg.


METHODS
After tracheal intubation, gastric fluid was aspirated via orogastric tube, and volume and pH of the aspirate were studied.


RESULTS
Significantly higher gastric volume occurred in group PP than groups EP, ER, or RM (P < 0.001). There were no differences in volumes among groups EP, ER, and RM. Gastric pH was significantly lower (P < 0.001) in groups PP and EP than in groups ER and RM.


CONCLUSIONS
Erythromycin and ranitidine combination is more efficacious than erythromycin alone in reducing the acidity and volume of gastric fluid. No difference was found between erythromycin-ranitidine and ranitidine-metoclopramide combination.
Bala
Indu
I
Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
Prasad
Krishna
K
Bhukal
Ishwar
I
Nakra
Dhiraj
D
Pratap
Monica
M
D000284:Administration, Oral; D000328:Adult; D000704:Analysis of Variance; D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000932:Antiemetics / Q000008:administration & dosage / Q000627:therapeutic use; D004917:Erythromycin / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005745:Gastric Acidity Determination; D005750:Gastric Juice / Q000737:chemistry / Q000187:drug effects*; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D006863:Hydrogen-Ion Concentration / Q000187:drug effects; D008297:Male; D008787:Metoclopramide / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D011292:Premedication; D011300:Preoperative Care / Q000379:methods; D011899:Ranitidine / Q000008:administration & dosage / Q000627:therapeutic use
D000897:Anti-Ulcer Agents; D000932:Antiemetics; D005765:Gastrointestinal Agents; D004917:Erythromycin; D011899:Ranitidine; D008787:Metoclopramide