Cimetidine in the Prevention of Acid Aspiration during Anesthesia

Abstract

In a controlled, randomized, double-blind trial, the value of cimetidine [H2 receptor blocker] as prophylaxis against acid aspiration pneumonitis was studied. Compared to placebo, CM reduced the volume as well as the acidity of the gastric contents significantly. The patients at risk of developing severe pneumonitis after aspiration (pH < 2.5 and volume > 20 ml) were reduced from 55% in the placebo group to 0 in the group having received CM 400 mg the night before and a further 400 mg on the morning of surgery. Premedication with CM may be useful if rapid intubation cannot be anticipated.