Toung T, Cameron J L
Surgery. 1980 Feb;87(2):205-8.
In an effort to decrease gastric residual and acid content prior to operation and thus to decrease the risk of aspiration, a prospective clinical trial comparing three drugs was carried out. Eighty-four patients undergoing elective craniotomy for a space-occupying lesion were studied. Twenty-eight patients were premedicated with the anticholinergic atropine (0.01 mg/kg); 28 patients were administered the anticholinergic glycopyrrolate (0.005 mg/kg); and 28 patients were given three preoperative doses of cimetadine and no anticholinergic. Gastric acidity was elevated above pH 2.5 in 93% of those receiving cimetadine, in comparison to 54% for glycopyrrolate and 29% with atropine. In addition, the stomach was completely dry in 54% following cimetadine, and in only 25% and 11% following glycopyrrolate and atropine. Cimetadine is more effective as a preanesthetic agent than anticholinergic drugs in decreasing gastric residual and acid content, and essentially eliminates the risk of aspiration.
为了在手术前降低胃残余物和胃酸含量，从而降低误吸风险，开展了一项比较三种药物的前瞻性临床试验。研究了84例因占位性病变接受择期开颅手术的患者。28例患者术前使用抗胆碱能药物阿托品（0.01mg/kg）进行预处理；28例患者使用抗胆碱能药物格隆溴铵（0.005mg/kg）；28例患者术前给予三次西咪替丁剂量且未使用抗胆碱能药物。接受西咪替丁治疗的患者中，93%的胃酸度升高至pH 2.5以上，相比之下，接受格隆溴铵治疗的患者为54%，接受阿托品治疗的患者为29%。此外，使用西咪替丁后，54%的患者胃完全排空，而使用格隆溴铵和阿托品后分别仅为25%和11%。作为麻醉前用药，西咪替丁在降低胃残余物和胃酸含量方面比抗胆碱能药物更有效，并且基本消除了误吸风险。
