Ranitidine and prevention of pulmonary aspiration syndrome

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Abstract
Thirty-seven patients undergoing elective abdominal surgery (excluding gastric operations) received either ranitidine 300 mg or placebo orally at 10 p.m. in the evening preceding surgery in a double-blind randomised study. The mean time interval between this oral premedication and induction of anaesthesia was 12 h. When compared to placebo, ranitidine decreased significantly (P < 0.05) the amount of gastric juice, and none of the ranitidine-treated patients had an increased risk of acid pulmonary aspiration (pH below 2.5 and volume over 25 ml), while four patients in the control group had an increased risk (21%). The mean ranitidine blood level was 237 ng/ml at the time of induction of anaesthesia. It is concluded that in elective abdominal surgery ranitidine included in the premedication is likely to decrease the risk for acid pulmonary aspiration.