Radev R, Frangov P, Khaimov M, Kozarov G, Ganev M
Khirurgiia (Sofiia). 1989;42(4):37-42.
In 210 patients divided in 7 groups depending on surgical disease or pregnancy the authors estimated pH of the gastric content during the preoperative period. It was found that pH was below 2.5, i.e. the acid level of the gastric content was high enough to present a hazard for appearance of Mendelson's syndrome, should eventual regurgitation or aspiration occur during or after general anesthesia. In an effort to prevent aspiration syndrome, apart from the most reliable and well know precaution "empty stomach", the authors suggest premedication with antacid drugs before the operation. They have applied Almagel A or Cimetidin 30 min before the operative intervention. The acid level of the gastric juice was thus reduced for about 1 1/2 hours to pH levels higher than the critical 3.5, so that in the event of eventual regurgitation and aspiration the gastric content would not cause severe respiratory injury. With their suggestion for use of antacid drugs during the preoperative period the authors expand the preoperative preparation of the patient for general anesthesia with set purpose to prevent respiration (Mendelson's) syndrome.
作者将210例患者根据外科疾病或妊娠情况分为7组，评估了术前胃内容物的pH值。结果发现，pH值低于2.5，即胃内容物的酸度足够高，若在全身麻醉期间或之后发生反流或误吸，就会有出现门德尔松综合征的风险。为预防误吸综合征，除了最可靠且广为人知的预防措施“空腹”外，作者建议在手术前使用抗酸药物进行术前用药。他们在手术干预前30分钟应用了氢氧化铝镁A或西咪替丁。胃液的酸度因此降低了约1个半小时，使pH值高于关键的3.5，这样万一发生反流和误吸，胃内容物就不会造成严重的呼吸损伤。作者建议在术前使用抗酸药物，从而有目的地扩展了患者全身麻醉的术前准备工作，以预防呼吸（门德尔松）综合征。
