1887

oa Southern African Journal of Anaesthesia and Analgesia - Esomeprazole as a prophylactic agent for acid aspiration syndrome in adult patients undergoing elective surgery : a triple blind placebo controlled clinical trial : original research

 

Abstract

To explore the effect of single oral dose of esomeprazole 20 mg, administered a night before surgery, on intragastric pH and volume in adult patients undergoing elective surgery by excluding cases contaminated with duodenogastric refluxate.


This prospective, triple blind, randomised and placebo controlled clinical trial was conducted to explore the effect of single oral dose of esomeprazole 20 mg, administered a night before surgery, on intragastric pH and volume on 120 adult inpatients of either sex, American Society of Anaesthesiologist physical status I-II, and aged 15-70 years. The patients in Group C (control) received placebo while Group E (Esomeprazole) received esomeprazole orally at 9.00 pm, the night before elective surgery. On the day of surgery, the gastric contents were aspirated with a large bore, multi-orifice gastric tube passed through an endotracheal tube placed blindly in the oesophagus after tracheal intubation and analysed for pH, volume and the presence of bile salts.
Thirty nine samples (33%) out of 117 were contaminated with duodenal contents. Duodenogastric reflux significantly affected pH and volume in Group C (p value 0.0003 and 0.0016) and E (p value 0.0401 and < 0.0001). Esomeprazole, after excluding samples contaminated with duodenal fluid, significantly increased pH (p < 0.0001), decreased volume (p 0.0068) and the percentage of the patients (2.56% versus 30.76%) considered "at risk" compared with placebo (p 0.0015) according to the criteria defined (pH ≤ 2.5 and volume ≥ 25 ml).
Esomeprazole 20 mg administered orally a night before elective surgery improved the gastric environment (pH < 2.5 and volume > 25 ml / kg) at the time of induction of anaesthesia excluding samples contaminated with duodenogastric reflux.

Loading

Article metrics loading...

/content/medsajaa/14/5/EJC73647
2008-09-01
2016-12-08
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error