title: Effect of preoperative oral erythromycin, erythromycin-ranitidine, and ranitidine-metoclopramide on gastric fluid pH and volume.
abstract: 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.
authors.affiliation: Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
authors.forename: Indu
authors.initials: I
authors.lastname: Bala
authors.forename: Krishna
authors.initials: K
authors.lastname: Prasad
authors.forename: Ishwar
authors.initials: I
authors.lastname: Bhukal
authors.forename: Dhiraj
authors.initials: D
authors.lastname: Nakra
authors.forename: Monica
authors.initials: M
authors.lastname: Pratap
mesh_terms: 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
chemical_list: D000897:Anti-Ulcer Agents; D000932:Antiemetics; D005765:Gastrointestinal Agents; D004917:Erythromycin; D011899:Ranitidine; D008787:Metoclopramide