Reduction of the Risk of Acid Pulmonary Aspiration in Anaesthetized Patients after Cimetidine Prernedication

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Abstract
Pulmonary damage caused by aspiration of vomited or regurgitated acid gastric contents continues to be a major risk threatening safe general anesthesia. Patients (42) undergoing elective general surgery received either placebo, cimetidine [CM] [histamine-2 receptor blocker] 300 mg, or CM 600 mg orally 1.5-2 h before anesthesia in a double-blind, randomized study. Another 13 subjects received no oral premedication and served as a control group. When compared to placebo or control patients, both doses of CM significantly decreased the acidity and volume of gastric contents. None of the subjects given CM were in the risk range of acid pulmonary aspiration (pH < 2.5 plus vol over 25 ml), whereas 46% of the control patients and 40% of the patients given placebo (P < 0.005 vs. CM in both groups) were in the risk range.