Nishimura M, Nakano S, Ueyama H, Uchiyama A, Tashiro C
Department of Anesthesiology, Osaka Medical Center, Japan.
J Clin Anesth. 1991 May-Jun;3(3):207-10. doi: 10.1016/0952-8180(91)90160-o.
To determine the feasibility and effects of preanesthetic rectal famotidine on gastric fluid pH and volume in pediatric patients.
Randomized, prospective, double-blind, controlled study.
Operating room at a medical center.
Eighty patients undergoing minor surgery under general anesthesia randomly allocated to one of two groups.
Thirty-four patients in Group 1 were given 0.5 mg/kg of diazepam rectally 30 to 120 minutes before anesthesia induction. Thirty-eight patients in Group 2 received 1 mg/kg of famotidine, a new histamine (H2) blocker, and 0.5 mg/kg of diazepam through the same route. Six patients in Group 1 and two patients in Group 2 were excluded from the study due to gastrointestinal (GI) disorders.
Patients with gastric pH less than 2.5 or volume of gastric contents greater than 0.4 ml/kg were considered to be at risk for pulmonary aspiration. Thirty-five (92%) of the Group 2 patients had gastric contents with pH greater than 2.5 and gastric volume less than or equal to 0.4 ml/kg. Only 13 (38%) of the patients in Group 1 had similar gastric pH and volume. Rectal administration did not cause the children pain, and no anorectal problems of famotidine were detected.
Famotidine 1.0 mg/kg administered rectally 30 minutes prior to general anesthesia appears to result in a satisfactory increase in gastric pH.
确定麻醉前直肠给予法莫替丁对小儿患者胃液pH值和容量的可行性及效果。
随机、前瞻性、双盲、对照研究。
某医疗中心手术室。
80例接受全身麻醉下小手术的患者随机分为两组。
第1组34例患者在麻醉诱导前30至120分钟经直肠给予0.5mg/kg地西泮。第2组38例患者经相同途径接受1mg/kg法莫替丁（一种新型组胺H2受体阻滞剂）和0.5mg/kg地西泮。第1组6例患者和第2组2例患者因胃肠道疾病被排除在研究之外。
胃液pH值小于2.5或胃内容物容量大于0.4ml/kg的患者被认为有发生肺误吸的风险。第2组35例（92%）患者的胃内容物pH值大于2.5且胃容量小于或等于0.4ml/kg。第1组仅13例（38%）患者有类似的胃液pH值和容量。直肠给药未引起儿童疼痛，且未检测到法莫替丁的肛肠问题。
全身麻醉前30分钟经直肠给予1.0mg/kg法莫替丁似乎能使胃液pH值得到令人满意的升高。
