Comparison of Cimetidine (Tagamet®) with Antacid for Safety and Effectiveness in Reducing Gastric Acidity before Elective Cesarean Section

Abstract

Parturients for elective cesarean section (126) under general anesthesia were allocated to either a cimetidine or an antacid group in a randomized, double-blind, multicenter trial [as a possible preventative agent for Mendelson''s syndrome]. The cimetidine-treated group received 300 mg cimetidine orally the evening before the operation and 300 mg i.v. between 1 and 3 h preoperatively. The antacid-treated group received 30 ml of Mylanta II orally on both occasions. Gastric volume, 30 min after induction of anesthesia and 30 min before response to oral commands, was less in the cimetidine-treated group. Gastric pH 30 min after induction was greater in the cimetidine-treated group. The maternal serum level of cimetidine at birth was 1.31 .+-. 0.12 .mu.g/ml and the umbilical venous level was 0.78 .+-. 0.05 .mu.g/ml. The neonatal gastric acidity, Apgar scores and Early Neonatal Neurobehavioral Scale (ENNS) scores were similar in both groups. No maternal or neonatal complication was attributed to treatment.