Aoki H, Chihara E, Tanaka H, Hosokawa T, Miyazaki M
Department of Anesthesiology, Kyoto Prefectural University of Medicine.
Masui. 1990 Jul;39(7):877-81.
The effect of preoperative oral and intramuscular ranitidine administration on intragastric pH and volume was evaluated in children. Thirty healthy inpatients whose ages were 2-13 years, were randomly assigned to three groups. Twelve hours before the elective operation apple juice was given to the control group, and apple juice with 0.4 mg.kg-1 ranitidine to the second group (Oral group). For the third group (IM group) an intramuscular injection of 0.1 mg.kg-1 ranitidine was done. Intragastric pH was significantly elevated and gastric volume was also significantly reduced in IM group, and serum ranitidine concentration showed a high level of 359.4 +/- 85.6 ng.dl-1 (mean +/- SD). In oral group ranitidine effect on pH and volume was not significant, and the drug serum concentration was 31.6 +/- 13.3 ng.dl-1 which was slightly lower than the effective level. Though the intramuscular injection guaranteed safer gastric content, a painful injection is stressful for children. With the knowledge of elimination rate of serum ranitidine we recommend oral ranitidine (0.4 mg.kg-1) six hours preoperatively for pediatric premedication.
研究评估了术前口服和肌肉注射雷尼替丁对儿童胃内pH值和胃容积的影响。30名年龄在2至13岁的健康住院患儿被随机分为三组。在择期手术前12小时，对照组给予苹果汁，第二组（口服组）给予含0.4mg/kg雷尼替丁的苹果汁，第三组（肌肉注射组）肌肉注射0.1mg/kg雷尼替丁。肌肉注射组胃内pH值显著升高，胃容积也显著减小，血清雷尼替丁浓度达到高水平的359.4±85.6ng/dl（平均值±标准差）。口服组中雷尼替丁对pH值和胃容积的影响不显著，药物血清浓度为31.6±13.3ng/dl，略低于有效水平。虽然肌肉注射能确保胃内容物更安全，但注射带来的疼痛会给儿童带来压力。鉴于血清雷尼替丁的消除率，我们建议术前6小时口服雷尼替丁（0.4mg/kg）用于小儿术前用药。
