PMID- 16192516
OWN - NLM
STAT- MEDLINE
DCOM- 20051021
LR  - 20210902
IS  - 0003-2999 (Print)
IS  - 0003-2999 (Linking)
VI  - 101
IP  - 4
DP  - 2005 Oct
TI  - The efficacy of preanesthetic proton pump inhibitor treatment for patients on 
      long-term H2 antagonist therapy.
PG  - 1038-1041
LID - 10.1213/01.ane.0000166979.99225.a0 [doi]
AB  - We previously reported that H2-antagonist medication given for longer than 4 wk 
      may produce complete tolerance to preanesthetic H2 antagonist therapy. In this 
      study, we evaluated the efficacy of preanesthetic proton pump inhibitor (PPI; 
      oral rabeprazol) use in patients receiving regular H2-antagonist (oral 
      famotidine) therapy for more than 4 wk. Forty-eight patients with assumed 
      complete tolerance to H2 antagonists undergoing elective surgery were recruited 
      and randomly assigned to receive either a preanesthetic PPI (rabeprazol 20 mg; n 
      = 24) or H2-antagonist (H2 group; roxatidine 75 mg; n = 24) at 9:00 pm on the day 
      before surgery and 2 h before the induction of anesthesia. Volume of gastric 
      contents and pH values were measured after the induction of anesthesia. Gastric 
      pH value in the PPI group (5.38 +/- 2.42) was significantly higher than in the H2 
      group (3.27 +/- 1.98; P < 0.01). Gastric volume in the PPI group (8.6 +/- 1.5 mL) 
      was significantly smaller than in the H2 group (15.4 +/- 2.8 mL; P < 0.05; cf. 
      PPI). Fourteen patients in the H2 group were at risk of acid aspiration pneumonia 
      (gastric pH <2.5 or volume >25 mL), whereas only four patients in the PPI group 
      (P < 0.05) were at risk. These data suggest that in patients receiving 
      H2-antagonist therapy for longer than 4 wk, prophylaxis for acid aspiration 
      pneumonia should include preanesthetic PPI medication. IMPLICATIONS: We 
      previously reported that more than 4 wk of administration of H2-antagonists may 
      produce a full tolerance to preanesthetic H2-antagonists. The present study 
      suggests that a proton pump inhibitor may be effective for prophylaxis of acid 
      aspiration pneumonia in patients showing the full tolerance to H2 antagonists.
FAU - Hirota, Kazuyoshi
AU  - Hirota K
AD  - Department of Anesthesiology, University of Hirosaki School of Medicine, Japan.
FAU - Kudo, Mihoko
AU  - Kudo M
FAU - Hashimoto, Hiroshi
AU  - Hashimoto H
FAU - Kushikata, Tetsuya
AU  - Kushikata T
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Anesth Analg
JT  - Anesthesia and analgesia
JID - 1310650
RN  - 0 (2-Pyridinylmethylsulfinylbenzimidazoles)
RN  - 0 (Anti-Ulcer Agents)
RN  - 0 (Benzimidazoles)
RN  - 0 (Gastrins)
RN  - 0 (Histamine H2 Antagonists)
RN  - 0 (Piperidines)
RN  - 0 (Proton Pump Inhibitors)
RN  - 32828355LL (Rabeprazole)
RN  - 5QZO15J2Z8 (Famotidine)
RN  - KG60484QX9 (Omeprazole)
RN  - ZUP3LSD0DO (roxatidine acetate)
SB  - IM
MH  - 2-Pyridinylmethylsulfinylbenzimidazoles
MH  - Adult
MH  - Aged
MH  - Anti-Ulcer Agents/*pharmacology
MH  - Benzimidazoles/pharmacology
MH  - Drug Tolerance
MH  - Famotidine/pharmacology
MH  - Female
MH  - Gastric Acidity Determination
MH  - Gastrins/blood
MH  - Histamine H2 Antagonists/*pharmacology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Omeprazole/analogs & derivatives/pharmacology
MH  - Piperidines/pharmacology
MH  - Pneumonia, Aspiration/*prevention & control
MH  - *Preanesthetic Medication
MH  - *Proton Pump Inhibitors
MH  - Rabeprazole
EDAT- 2005/09/30 09:00
MHDA- 2005/10/22 09:00
CRDT- 2005/09/30 09:00
PHST- 2005/09/30 09:00 [pubmed]
PHST- 2005/10/22 09:00 [medline]
PHST- 2005/09/30 09:00 [entrez]
AID - 00000539-200510000-00020 [pii]
AID - 10.1213/01.ane.0000166979.99225.a0 [doi]
PST - ppublish
SO  - Anesth Analg. 2005 Oct;101(4):1038-1041. doi: 10.1213/01.ane.0000166979.99225.a0.