Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Baclofen/therapeutic use , Rumination Syndrome/drug therapy , Muscle Relaxants, Central/therapeutic use , Double-Blind Method , Reproducibility of Results , Treatment Outcome , Cross-Over Studies , Evidence-Based Medicine , Eructation/drug therapy , Laryngopharyngeal Reflux/drug therapyABSTRACT
The objective of this study was to perform a systematic review and meta-analysis to assess the effectiveness of proton pump inhibitors (PPI) for reflux disease in adult patients with laryngopharyngeal symptoms. A comprehensive search of Cochrane Library, EMBASE, Ovid EBM Reviews, and PubMed was performed for English-language literature about laryngopharyngeal reflux (LPR), in September 2014. The papers were filtered using pre-defined inclusion and exclusion criteria. Eight papers were identified and included in this meta-analysis. The sample comprised a pooled total of 370 patients, of which 210 and 160 patients took PPIs and placebo, respectively. The difference between PPIs and placebo groups in overall improvement of symptoms in adult patients with LPR was not statistically significant (RR=1.22; 95%CI=0.93-1.58; P=0.149). The difference in cough improvement was also not significant between PPIs and placebo groups (RR=0.65; 95%CI=0.30-1.41; P=0.279).
Subject(s)
Humans , Male , Female , Adult , 2-Pyridinylmethylsulfinylbenzimidazoles/therapeutic use , Proton Pump Inhibitors/therapeutic use , Laryngopharyngeal Reflux/drug therapy , Placebo Effect , Treatment OutcomeABSTRACT
Acid aspiration syndrome at the induction of anesthesia is still a potentially life-threatening complication. Its severity is affected by both PH and volume of the gastric juice that is aspirated. The aim of this study was to evaluate the effect of esomeprazole versus pantoprazole or ranitidine on gastric acid secretion and volume during induction of anesthesia. 160 patients of both sexes. ASA I-II, aged 20-60 years were included in this study. Patients were randomly assigned to one of four groups [n=40 each] group I [given oral esomeprazole 40mg at 9 PM on the evening before surgery and 40 mg 2 hours before surgery], group II [given oral pantoprazole 40mg at 9PM on the evening before surgery and 40mg 2 hours before surgery], group III [given oral ranitidine 150mg at 9PM on the evening before surgery and 150 mg 2 hours before surgery], and group IV [placebo group]. As regard the volume of the aspirated gastric fluid there was no significant difference between group I, group II, and group Ill but there was significant increase in group IV in comparison to the other three study groups. The pH of aspirated gastric fluid was significantly higher in group I while it was significantly lower in group IV in comparison to the other three study groups. But there was no significant difference between group II, and group III. Number of patients considered at risk for aspiration pneumonitis as defined by a gastric fluid pH of /= 25 ml was significantly higher in group IV in comparison to the other three study groups. With the use of esomeprazole, pantoprazole, and ranitidine preoperative gastric fluid environment was improved in relation to placebo. Oral esomeprazole was more effective than oral pantoptazole or oral ranitidine in increasing the preoperative gastric aspirate pH and thus reduce the proportion of patients at risk of significant lung injury if aspiration occurred. There was no significant difference between oral pantoprazole and oral ranitidine