ORIGINAL ARTICLE – Comparative study of oral erythromycin-ranitidine combination and metoclopramide-ranitidine combination in reducing residual gastric fluid volume and acidity in elective surgery

Abstract

Background: Prokinetic agents and H-2 receptor antagonists are commonly used to decrease the volume and increase the pH of the gastric fluid. This study was conducted to compare the effect of oral erythromycin–ranitidine combination and metoclopramide–ranitidine combination in reducing gastric fluid volume and acidity in patients undergoing elective surgery.

Methodology: 80 patients were divided into two groups by convenient sampling technique after meeting inclusion criteria; Group A was given oral erythromycin 250 mg-ranitidine 150 mg while group B was given oral metoclopramide 10 mg-ranitidine 150 mg two hours before surgery. Gastric fluid was aspirated with orogastric tube after induction. Volume and pH of the gastric fluid were determined.

Results: Data analysis of our study showed statistically significant reduction in mean gastric fluid aspirate volume in group A (3.4ml+2.3 vs. 7.2ml+3.1). (P-value = 0.001 and T-value = 6.24). There was no statistically significant difference between the two groups as far as increase in gastric pH was concerned (6.5+1.6 vs. 6.2+1.3). (T-value = 0.925 / Two tailed P-value = 0.36). In both the groups’ gastric pH was increased from the average normal value (0.3-2.9).

Conclusion: Combination of erythromycin-ranitidine is more effective than metoclopramide-ranitidine in reducing the gastric aspirate fluid volume and thus in prevention of acid aspiration syndrome.

Citation: Afzal S, Sheikh AN, Chaudary IW, Iftikhar Z. Comparative study of oral erythromycin-ranitidine combination and metoclopramide-ranitidine combination in reducing residual gastric fluid volume and acidity in elective surgery. Anaesth Pain & Intensive Care 2009;13(2);61-64