Ranitidine and single‐dose antacid therapy as prophylaxis against acid aspiration syndrome in obstetric practice

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Abstract
Summary: The efficacy of the non‐particulate antacid 0.3 M sodium citrute in single and multiple dose regimes was investigated in 156 obstetric patients, both emergency and elective, who required operative delivery under general anasthesia. Failure of either of these regimes to elevate the intragastric pH consistently to an ucceptuhle level (> 3) led to investigation of a regime combining the histamine H 2 ‐receptor antugonist. ranitidine, and a single pre‐anasthetic dose of 0.3 M sodium citrate in a further I70 patients. Satisfactory pH values (>3) were achieved in all patients studied. The results from the first 99 cases were analysed statistically by comparison with the multiple dose sodium citrate regime and showed a very significant improvement in the ranitidine group for intragastric pH and volume. No untoward side‐effects were discovered in either mother or baby and the 6‐hourly administration of ranitidine, which was easily complied with, had no eflect on the progress of labour or operutive delivery rate.