Effect of Oral Liquids and Ranitidine on Gastric Fluid Volume and pH in Children Undergoing Outpatient Surgery

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Abstract
Eighty-eight children (mean age 5.6 yr, range 1-14 yr) about to undergo elective outpatient surgery were randomly assigned to four groups. All children were given phenolsulfonphthalein (PSP) orally 2-3 h before the scheduled time of surgery as a marker dye to assess gastric emptying. Immediately after receiving PSP they were given: group A.sbd.liquids, up to 5 ml/kg + placebo (glucose water 0.2 ml/kg); group B.sbd.liquids, up to 5 ml/kg + ranitidine 2 mg/kg in glucose water 0.2 ml/kg; group C.sbd.placebo only; group D.sbd.ranitidine only. Gastric contents were aspirated after induction of anesthesia. Mean volume (range) in ml/kg of aspirated gastric fluid in each group was: group A.sbd.3.4 (1-10); group B.sbd.0.17 (0-0.7); group C.sbd.2.5 (0-1.1); group D.sbd.0.16 (0-0.6). The pH mean (range) value was: group A.sbd.1.83 (0.9-3.6); group B.sbd.4.76 (2.0-7.7); group C.sbd.2.10 (1.2-4.1); group D.sbd.3.97(1.3-7.3). PSP could not be detected in the gastric samples from children in whom the ingestion-sampling interval was more than 2.25 h. In comparison with prolonged starvation, administration of oral liquids without ranitidine 2-3 h preoperatively did not produce a significant increase in mean volume of gastric aspirate, and there was no increase in the number of patients with gastric aspirate greater than 0.4 ml/kg. Administration of ranitidine with or without fluids resulted in a decrease in both volume and acidity of gastric contents.