Effect of oral liquids and ranitidine on gastric fluid volume and pH in children undergoing outpatient surgery

Abstract

Eighty-eight children (mean age 5.6 yr, range 1-14 yr) about to undergo elective outpatient surgery were randomly assigned to four groups. All children were given phenolsulfonphthalein (PSP) orally 2-3 h before the scheduled time of surgery as a marker dye to assess gastric emptying. Immediately after receiving PSP they were given: group A - liquids, up to 5 ml/kg + placebo (glucose water 0.2 ml/kg); group B - liquids, up to 5 ml/kg + ranitidine 2 mg/kg in glucose water 0.2 ml/kg; group C - placebo only; group D - ranitidine only. Gastric contents were aspirated after induction of anesthesia. Mean volume (range) in ml/kg of aspirated gastric fluid in each group was; group A - 0.34 (0-1.0); group B - 0.17 (0-0.7); group C - 0.25 (0-1.1); group D - 0.16 (0-0.6). The pH mean (range) value was: group A - 1.83 (0.9-3.6); group B - 4.76 (2.0-7.7); group C - 2.10 (1.2-4.1); group D-3.97 (1.3-7.3). PSP could not be detected in the gastric samples from children in whom the ingestion-sampling interval was more than 2.25 h. In comparison with prolonged starvation, administration of oral liquids without ranitidine 2-3 h preoperatively did not produce a significant increase in mean volume of gastric aspirate, and there was no increase in the number of patients with gastric aspirate greater than 0.4 ml/kg. Administration of ranitidine with or without fluids resulted in a decrease in both volume and acidity of gastric contents.