Effect of Preanesthetic Cimetidine on Gastric pH and Volume of Patients for Elective Cesarean Section / 대한마취과학회지

Aspiratian of gastric contents during anesthesia is the most common cause of maternal anesthetic death. Particularly, the parturient is predisposed to the catastrophe of aspiration for many reasons. So, the effect of cimetidine premedication on gastric pH and volume were studied. 120 ASA Class I patients scheduled for elective obstetric and gynecologic surgery were randomly divided into six groups as follows: Class A(n=80) is pregnant women scheduled for elective cesarean section. In the class A, group 1(n=20)(control group) was received no cimetidine premedication, group 2(n=20) was received cimetidine 300 mg p.o. hs. group 3(n=20) was received cimetidine 300 mg p.o. 2hrs before anesthesia, and group 4(n=20) was received cimetidine 200 mg iv 2hrs before anesthesia. Class B (n=40) is 20-40 aged non-pregnant women scheduled for elective surgery. ln the class B, group 5(n=20)(control group) was received no cimetidine premedication and group 6(n=20) was received cimetidine 200 mg iv 2hrs before anesthesia. Immediately following induction of anesthesia, the gastric fluid was obtained by suction on a nasogastric tube and its volume and pH were measured. The results were as follows: 1) When cimetidine is not premedicated, number of patient with a gastric pH less than 2,5 and gastric volume greater than 25 ml was increased in the group 1 compared with group 5. 2) In the class A, there was significant increased gastric pH and decreased gastric volume in the group 2, 3, and 4 compared with group l. 3) In the class B, there was significant increased gastric pH and decreased gastric volume in the group 6 compared with group 5. In conclusion, it would seem that the risk of aspiration pneumonitis can be increased in the pregnant women compared with nonpregnant women. The authors recommend that the incidence of severe aspiration pneumonia can be decreased by cimetidine premedication before general anesthesia even though there is any gastric aspiration.

Effect of the Amount of Crying on the Gastric Acidity and Volume in Pediatric Surgical Patients / 대한마취과학회지

It has been already demonstrated that the gastric acidity of crying pediatric surgical patients were less acidic than that of non-crying patients by Cote CJ and his collegues. Under the postulation that the changes of the gastric acidity and volume of crying patients might not be the same according to the amount of crying(duration or crying), this study was undertaken. 81 ASA physical status 1-2 children ages 1-14 for 1st elective operation except gastrointesti- nal surgery were selected randomly and divided into 2 groups and subdivided into 2 groups as follows: Group 1 (n=39~7, not cried Group 2 (n=42g cried Group A (n=14R cried in RR and OR Group B (n=28); cried in OR Subgoup B-1 (n= 11~7, cried as soon as arrived in OR Subgroup B-2 (n = 17); cried when attached monitoring and/or started IV All patients were premedicated with glycopyrrolate and hydroxyzine. Gastric samples were obtained through nasogastric tube and measured pH values with TOA PH METER MODEL HM-SES immediately after induction. The results were as follows; 1) Gastric pH In the changes of the mean pH values, there were statistical significances between groups 1 and 2(P or = 0.4 ml/kg) between groups 1 and 2, and between subgroups B-1 and B-2, but there were significant differences between groups A and B, and between group A and subgroup B-2 (p <0.05).