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Effects of preoperative medications on gastric pH, volume, and flora
Aspiration of acid gastric juice poses a potential threat during operations. Many anesthesiologists use a variety of agents aimed at decreasing gastric volume and/or acidity. The effect of three agents on gastric volume, pH, and flora, and the effect of cefazolin on gastric flora in morbidly obese p...
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| Published in: | Annals of surgery 1986-06, Vol.203 (6), p.614-619 |
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| Main Authors: | , , , , , |
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| container_end_page | 619 |
| container_issue | 6 |
| container_start_page | 614 |
| container_title | Annals of surgery |
| container_volume | 203 |
| creator | LAWS, H. L BRYANT, J. W PALMER, M. D BOUDREAUX, A. M DONALD, J. M. JR SCOTT WHEELER, A |
| description | Aspiration of acid gastric juice poses a potential threat during operations. Many anesthesiologists use a variety of agents aimed at decreasing gastric volume and/or acidity. The effect of three agents on gastric volume, pH, and flora, and the effect of cefazolin on gastric flora in morbidly obese patients were studied. Cefazolin did not sterilize the gastric lumen. Almost one-half of patients not treated with an H2 blocker had a pH below 2.5 and a gastric volume of 20 ml or more. Five had both a low pH and significant volume and, thus, the potential for lethal aspiration. Two doses of cimetidine, 300 mgm orally, or of ranitidine, 150 orally, the evening before and the morning of operation decreased gastric volume and raised pH reliably to a level that should be protective from fatal aspiration. However, gastric cultures after these drugs were positive 86% of the time with a larger variety of organisms than in the untreated stomachs. Metoclopramide failed to decrease gastric volume or raise pH. Transoperative cefazolin was used in all patients. Clinical infection was not a problem. |
| doi_str_mv | 10.1097/00000658-198606000-00005 |
| format | article |
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Two doses of cimetidine, 300 mgm orally, or of ranitidine, 150 orally, the evening before and the morning of operation decreased gastric volume and raised pH reliably to a level that should be protective from fatal aspiration. However, gastric cultures after these drugs were positive 86% of the time with a larger variety of organisms than in the untreated stomachs. Metoclopramide failed to decrease gastric volume or raise pH. Transoperative cefazolin was used in all patients. Clinical infection was not a problem.</description><identifier>ISSN: 0003-4932</identifier><identifier>EISSN: 1528-1140</identifier><identifier>DOI: 10.1097/00000658-198606000-00005</identifier><identifier>PMID: 3521506</identifier><identifier>CODEN: ANSUA5</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Anesthetics. Neuromuscular blocking agents ; Anti-Bacterial Agents - pharmacology ; Anti-Bacterial Agents - therapeutic use ; Biological and medical sciences ; Clinical Trials as Topic ; Double-Blind Method ; Gastric Juice - analysis ; Gastric Juice - drug effects ; Gastric Juice - microbiology ; Gastrostomy ; Humans ; Hydrogen-Ion Concentration ; Medical sciences ; Metoclopramide - therapeutic use ; Neuropharmacology ; Obesity - surgery ; Pharmacology. Drug treatments ; Preanesthetic Medication ; Prospective Studies ; Random Allocation ; Ranitidine - therapeutic use ; Stomach - microbiology ; Stomach - surgery</subject><ispartof>Annals of surgery, 1986-06, Vol.203 (6), p.614-619</ispartof><rights>1987 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c444t-45c6b77409e156cdea4767d77a09d4061d1c41de22903d9f0c2925d7d89426183</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1251188/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1251188/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,309,310,314,727,780,784,789,790,885,23930,23931,25140,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=8262982$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/3521506$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>LAWS, H. L</creatorcontrib><creatorcontrib>BRYANT, J. W</creatorcontrib><creatorcontrib>PALMER, M. D</creatorcontrib><creatorcontrib>BOUDREAUX, A. M</creatorcontrib><creatorcontrib>DONALD, J. M. JR</creatorcontrib><creatorcontrib>SCOTT WHEELER, A</creatorcontrib><title>Effects of preoperative medications on gastric pH, volume, and flora</title><title>Annals of surgery</title><addtitle>Ann Surg</addtitle><description>Aspiration of acid gastric juice poses a potential threat during operations. Many anesthesiologists use a variety of agents aimed at decreasing gastric volume and/or acidity. The effect of three agents on gastric volume, pH, and flora, and the effect of cefazolin on gastric flora in morbidly obese patients were studied. Cefazolin did not sterilize the gastric lumen. Almost one-half of patients not treated with an H2 blocker had a pH below 2.5 and a gastric volume of 20 ml or more. Five had both a low pH and significant volume and, thus, the potential for lethal aspiration. Two doses of cimetidine, 300 mgm orally, or of ranitidine, 150 orally, the evening before and the morning of operation decreased gastric volume and raised pH reliably to a level that should be protective from fatal aspiration. However, gastric cultures after these drugs were positive 86% of the time with a larger variety of organisms than in the untreated stomachs. Metoclopramide failed to decrease gastric volume or raise pH. Transoperative cefazolin was used in all patients. Clinical infection was not a problem.</description><subject>Anesthetics. Neuromuscular blocking agents</subject><subject>Anti-Bacterial Agents - pharmacology</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Clinical Trials as Topic</subject><subject>Double-Blind Method</subject><subject>Gastric Juice - analysis</subject><subject>Gastric Juice - drug effects</subject><subject>Gastric Juice - microbiology</subject><subject>Gastrostomy</subject><subject>Humans</subject><subject>Hydrogen-Ion Concentration</subject><subject>Medical sciences</subject><subject>Metoclopramide - therapeutic use</subject><subject>Neuropharmacology</subject><subject>Obesity - surgery</subject><subject>Pharmacology. Drug treatments</subject><subject>Preanesthetic Medication</subject><subject>Prospective Studies</subject><subject>Random Allocation</subject><subject>Ranitidine - therapeutic use</subject><subject>Stomach - microbiology</subject><subject>Stomach - surgery</subject><issn>0003-4932</issn><issn>1528-1140</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1986</creationdate><recordtype>article</recordtype><recordid>eNpVUctKBDEQDKLouvoJQg7iydF0Js-LIL5hwYueQ0wyOjI7GZPZBf_erK6L5tJJVXWl6UIIAzkDouU5WR3BVQVaCSLKo1ohfAtNgNMCAyPbaFKgumK6pntoP-d3QoApInfRbs0pcCIm6PqmaYIbM44NHlKIQ0h2bJcBz4NvXbnGvnA9frV5TK3Dw_0pXsZuMQ-n2PYeN11M9gDtNLbL4XBdp-j59ubp6r6aPd49XF3OKscYGyvGnXiRkhEdgAvng2VSSC-lJdozIsCDY-ADpZrUXjfEUU25l15pRgWoeooufnyHxUuZz4V-TLYzQ2rnNn2aaFvzn-nbN_MalwYoB1Arg5O1QYofi5BHM2-zC11n-xAX2UihFJVAilD9CF2KOafQbD4BYlYJmN8EzCaBb4iX1qO_Q24a1ysv_PGat9nZrkm2d23eyBQVVCtafwGK3I1j</recordid><startdate>19860601</startdate><enddate>19860601</enddate><creator>LAWS, H. L</creator><creator>BRYANT, J. W</creator><creator>PALMER, M. D</creator><creator>BOUDREAUX, A. M</creator><creator>DONALD, J. M. JR</creator><creator>SCOTT WHEELER, A</creator><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>19860601</creationdate><title>Effects of preoperative medications on gastric pH, volume, and flora</title><author>LAWS, H. L ; BRYANT, J. W ; PALMER, M. D ; BOUDREAUX, A. M ; DONALD, J. M. JR ; SCOTT WHEELER, A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c444t-45c6b77409e156cdea4767d77a09d4061d1c41de22903d9f0c2925d7d89426183</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1986</creationdate><topic>Anesthetics. Neuromuscular blocking agents</topic><topic>Anti-Bacterial Agents - pharmacology</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Clinical Trials as Topic</topic><topic>Double-Blind Method</topic><topic>Gastric Juice - analysis</topic><topic>Gastric Juice - drug effects</topic><topic>Gastric Juice - microbiology</topic><topic>Gastrostomy</topic><topic>Humans</topic><topic>Hydrogen-Ion Concentration</topic><topic>Medical sciences</topic><topic>Metoclopramide - therapeutic use</topic><topic>Neuropharmacology</topic><topic>Obesity - surgery</topic><topic>Pharmacology. Drug treatments</topic><topic>Preanesthetic Medication</topic><topic>Prospective Studies</topic><topic>Random Allocation</topic><topic>Ranitidine - therapeutic use</topic><topic>Stomach - microbiology</topic><topic>Stomach - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>LAWS, H. L</creatorcontrib><creatorcontrib>BRYANT, J. W</creatorcontrib><creatorcontrib>PALMER, M. D</creatorcontrib><creatorcontrib>BOUDREAUX, A. M</creatorcontrib><creatorcontrib>DONALD, J. M. JR</creatorcontrib><creatorcontrib>SCOTT WHEELER, A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>LAWS, H. L</au><au>BRYANT, J. W</au><au>PALMER, M. D</au><au>BOUDREAUX, A. M</au><au>DONALD, J. M. JR</au><au>SCOTT WHEELER, A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of preoperative medications on gastric pH, volume, and flora</atitle><jtitle>Annals of surgery</jtitle><addtitle>Ann Surg</addtitle><date>1986-06-01</date><risdate>1986</risdate><volume>203</volume><issue>6</issue><spage>614</spage><epage>619</epage><pages>614-619</pages><issn>0003-4932</issn><eissn>1528-1140</eissn><coden>ANSUA5</coden><abstract>Aspiration of acid gastric juice poses a potential threat during operations. Many anesthesiologists use a variety of agents aimed at decreasing gastric volume and/or acidity. The effect of three agents on gastric volume, pH, and flora, and the effect of cefazolin on gastric flora in morbidly obese patients were studied. Cefazolin did not sterilize the gastric lumen. Almost one-half of patients not treated with an H2 blocker had a pH below 2.5 and a gastric volume of 20 ml or more. 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| ispartof | Annals of surgery, 1986-06, Vol.203 (6), p.614-619 |
| issn | 0003-4932 1528-1140 |
| language | eng |
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| subjects | Anesthetics. Neuromuscular blocking agents Anti-Bacterial Agents - pharmacology Anti-Bacterial Agents - therapeutic use Biological and medical sciences Clinical Trials as Topic Double-Blind Method Gastric Juice - analysis Gastric Juice - drug effects Gastric Juice - microbiology Gastrostomy Humans Hydrogen-Ion Concentration Medical sciences Metoclopramide - therapeutic use Neuropharmacology Obesity - surgery Pharmacology. Drug treatments Preanesthetic Medication Prospective Studies Random Allocation Ranitidine - therapeutic use Stomach - microbiology Stomach - surgery |
| title | Effects of preoperative medications on gastric pH, volume, and flora |
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