[A comparison of oral- and intramuscular-preoperative administration of ranitidine in children].

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.