ABSTRACT
Gastric pH and volume were measured in 87 patients who had received i.v. omeprazole (a new gastric antisecretory agent) 40 mg or placebo 1 or 3 h before surgery. Omeprazole increased the pH of gastric contents in the majority of patients. Administration 1 h before surgery produced greater gastric pH and smaller volume than administration 3 h before surgery. There was a reduction in the number of patients with a pH of less than 2.5 and a volume of 25 ml or more in the treated groups compared with the combined placebo groups. Omeprazole may have a role in prophylaxis against acid aspiration syndrome.
Subject(s)
Gastrointestinal Contents/drug effects , Omeprazole/pharmacology , Adolescent , Adult , Aged , Anesthesia, General , Double-Blind Method , Female , Humans , Hydrogen-Ion Concentration , Male , Middle Aged , Omeprazole/therapeutic use , Pneumonia, Aspiration/prevention & control , Premedication , Time FactorsABSTRACT
1. The effects of metoclopramide or cisapride on morphine-induced delay in gastric emptying in patients before surgery were compared. 2. Forty patients were allocated randomly to receive one of four premedications i.m.: placebo only, morphine 10 mg alone, morphine 10 mg with metoclopramide 10 mg and morphine 10 mg with cisapride 10 mg. Gastric emptying after each premedication was assessed indirectly from the rate of absorption of oral paracetamol. 3. Cisapride 10 mg reversed the delay in gastric emptying due to morphine. Its effects were significantly greater than those of metoclopramide 10 mg.
Subject(s)
Gastric Emptying/drug effects , Metoclopramide/pharmacology , Morphine/adverse effects , Piperidines/pharmacology , Acetaminophen/pharmacokinetics , Adolescent , Adult , Cisapride , Clinical Trials as Topic , Double-Blind Method , Female , Humans , Intestinal Absorption , Male , Middle Aged , Morphine/blood , Premedication , Random Allocation , Time FactorsABSTRACT
A case is described in which a Jehovah's Witness underwent emergency surgery following which her haemoglobin fell to 1.8 g/d litre. She was successfully treated in an intensive care unit with intermittent positive pressure ventilation of the lungs, high inspired oxygen concentrations and transfusions of large volumes of gelatin solution.
