11278
document
Gastroesophageal reflux and tracheal aspiration in the thoracotomy position : should ranitidine premedication be routine ? UNLABELLED Aspiration of gastric contents may contribute to pulmonary complications after thoracotomy . The incidence of gastroesophageal reflux ( GER ) and tracheal acid aspiration in patients undergoing thoracotomy in the lateral position is unknown . Ranitidine premedication reduces gastric volume , increases gastric pH , and may reduce GER . We used continuous intraluminal esophageal and tracheal pH monitoring probes to investigate the effect of ranitidine on the incidence of GER and tracheal aspiration in 80 adult patients undergoing thoracotomy . The study was placebo-controlled , randomized , and double-blinded . Patients at high risk of GER were excluded from the study . The incidence of acid GER in the placebo and ranitidine groups was 28.2 % and 2.5 % , respectively ( P = 0.006 ) . Multiple episodes of GER occurred in some patients in the placebo group only . The total number of episodes of GER in the placebo and ranitidine groups was 16 and 1 , respectively ( P = 0.002 ) . The incidence of tracheal acid aspiration in the placebo and ranitidine groups was 7.7 % and 2.5 % , respectively ( not significant ) . Patients undergoing thoracotomy are therefore at high risk of acid GER , which may lead to tracheal acid aspiration in an appreciable proportion . Premedication with ranitidine significantly reduces , but does not eliminate , the incidence of this potentially life-threatening complication . IMPLICATIONS Gastroesophageal reflux ( GER ) and tracheal aspiration of acid may increase morbidity and mortality in patients undergoing thoracotomy . This randomized , double-blinded , placebo-controlled study demonstrates frequent incidences of both acid GER and tracheal acid aspiration during surgery that are significantly reduced by premedication with ranitidine .
11279
Intervention_Pharmacological
ranitidine
11280
Intervention_Pharmacological
Ranitidine
11281
Intervention_Pharmacological
ranitidine
11282
Intervention_Control
placebo-controlled
11283
Intervention_Pharmacological
placebo
11284
Intervention_Pharmacological
ranitidine
11285
Intervention_Pharmacological
placebo
11286
Intervention_Pharmacological
ranitidine
11287
Intervention_Pharmacological
placebo
11288
Intervention_Pharmacological
ranitidine
11289
Intervention_Surgical
thoracotomy
11290
Intervention_Pharmacological
ranitidine
11291
Intervention_Surgical
thoracotomy
11292
Intervention_Control
placebo-controlled
11293
Intervention_Pharmacological
ranitidine
11294
Outcome_Physical
gastroesophageal reflux ( GER )
11295
Outcome_Physical
tracheal acid aspiration
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Outcome_Physical
GER
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Outcome_Physical
GER
11298
Outcome_Physical
tracheal aspiration
11299
Outcome_Physical
incidence of acid GER
11300
Outcome_Physical
episodes of GER
11301
Outcome_Physical
total number of episodes of GER
11302
Outcome_Physical
incidence of tracheal acid aspiration
11303
Outcome_Physical
risk of acid GER
11304
Outcome_Physical
tracheal acid aspiration
11305
Outcome_Physical
Gastroesophageal reflux ( GER )
11306
Outcome_Physical
tracheal aspiration of acid
11307
Outcome_Physical
acid GER
11308
Outcome_Physical
tracheal acid aspiration
11309
Participant_Condition
patients undergoing thoracotomy in the lateral position
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Participant_Sample-size
80