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The prevention of mendelson's syndrome oral and intravenous administration of ranitidine zantac

, : The prevention of mendelson's syndrome oral and intravenous administration of ranitidine zantac. Clinical Trials Journal 23(3): 193-200

Aspiration of acid material from the stomach into the airways can cause acute pneumonia (Mendelson's Syndrome). Damage to the airways' mucosa occurs when the regurgitated material has a pH of 2.5 or lower, and patients at greatest risk are those under general anaesthesia, particularly women undergoing Caesarean section. A study was made therefore to evaluate the efficacy of ranitidine (Zantac), given orally or intravenously, in reducing titratrable acidity and increasing the pH of the gastric secretion by comparison with a control group receiving no pharmaceutical therapy. Twenty patients undergoing emergency Caesarean section were given an i.v. infusion of 100 ml of physiological saline with one ampoule (50 mg) of ranitidine, 45 minutes before anaesthetic induction was started, the infusion taking five minutes. Twenty-two patients undergoing elective Caesarean section were given orally 1 .times. 150 mg tablet of ranitidine at 2300 hours on the evening before operation and a second 150 mg tablet at 0700 hours the next morning, about two hours before operation. The control group consisted of nine Caesarean section patients (three elective, six emergency) who received no pharmaceutical treatment. Ranitidine treatment resulted in a significant increase in pH and a corresponding reduction in titratable acidity, the reduction being greater in the orally-treated group and being seen in all gastric juice samples aspirated. In i.v.-treated group, significant increases from control values were obtained only in pre-induction aspirates and the samples aspirated at the 30-minute intervals prior to the end of operation. Ranitidine blood levels in maternal and umbilical cord blood showed the limited transplacental movement of the drug, thereby indicating its suitability in the prophylaxis of Mendelson's Syndrome.

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