RéSUMé
La cimétidine administrée à la dose de 400 mg par voie intramusculaire 60 minutes avant le début de l’anesthésie diminue l’acidité gastrique durant toute l’anesthésie générale, sans modifier significativement le volume des sécrétions. Elle diminue le pourcentage des sujets présentant un pH gastrique inférieur à 2,5 à l’induction et au réveil.
La cimétidine ne semble pas modifier le profil d’action des produits couramment utilisés en anesthésie. Elle n’entraîne pas de modifications significatives des principaux paramètres cardiovasculaires et électrocardiographiques.
Abstract
Cimetidine 400 mg was administered intramuscularly 60 minutes before the beginning of general anaesthesia. The double blind experiment was conducted on 84 patients divided in two groups: cimetidine and control. There was no difference in gastric fluid volume between the two groups during general anaesthesia, but acid secretion decreased significantly in the cimetidine group. Values of pH lower than 2.5 were observed in 33.3 percent at induction and 34 per cent at recovery in the control group against 14.6 per cent and 0 per cent in the cimetidine group.
Clinical tolerance to cimetidine was studied in 100 patients during operation. Cimetidine did not alter pharmacological action of usual anaesthetics. There were no significant changes in cardiovascular and electrocardiographic data.
Article PDF
Bibliographie
Bannister, W.K. &Satillaro, A. J. Vomiting and aspiration during anesthesia. Anesthesiology,25, 251–264 (1962).
Baraka, A., Saab, M., Salem, M.R. &Winnie, A.P. Control of gastric acidity by glycopyrrolate premedication in the parturient. Anesth. Anal.,56, 642–645 (1977).
Bond, V.K., Soelting, R.K. &Gupta, C.D. Pulmonary aspiration syndrome after inhalation of gastric fluid containing antacids. Anesthesiology,51, 452–453 (1979)
Bournerias, F., Ganeval, D. &Danan, G. Trouble du rythme cardiaque mortel au cours d’un traitement par la cimétidine. Nouv. Presse Med.,7, 2069 (1978).
Clifton, B.S. &Hotten, W.I.T. Deaths associated with anaesthesia. Brit. J. Anaesth.,35, 250- 259 (1963).
Cohen, J., Weetman, A.P., Dargie, H.D. &Krikler, D.M. Life-threatening arrhythmias and intravenous cimetidine. Brit. Med. J.,2,768 (1979).
Coombs, D.W., Hooper, D. &Colton, T. Preanesthetic cimetidine alteration of gastric fluid volume and pH. Anesth. Anal.,58, 183–188(1979).
Coombs, D.W., Hooper, D. &Colton, T. Acid- aspiration prophylaxis by use of preoperatory oral administration of cimetidine. Anesthesiology,51, 352–356 (1979).
Crawford J.S. The anesthetist’s contribution to maternal mortality. Brit. J. Anaesth.,42, 70–73 (1970).
Culver, G.A., Makel, H.P. &Beecher, H.K. Frequency of aspiration of gastric contents by the lungs during anesthesia and surgery. Ann. Surg.,133, 289–292 (1951).
Deforest, J.M. &Hollis, Th.M. Shear stress and aortic histamine synthesis. Am. J. Physiol.,234, H. 701–705 (1978).
Delaney, J.P., Michel, H.M. &Bond, J.P. Cimetidine and gastric blood flow. Surgery,84, 190–193 (1978).
Delchier, J.C., Soule, J.C. &Bader, J.P. La cimetidine: Pharmacologie et toxicité. Nouvelle Presse. Med.,7, 1735–1739(1978).
Detmer, M.D., Pandit, S.K. &Cohen, P.J. Prophylactic single dose oral antacid therapy in the preoperative period comparison of cimetidine and Maalox®. Anesthesiology,51, 270–273 (1979).
Dinnick, O.P. Deaths associated with anaesthesia. Observations on 600 cases. Anaesthesia,19, 536- 556 (1964).
Dobb, G., Jordan, M.J. &Williams, J.G. Cimetidine in the prevention of the pulmonary acid aspiration (Mendelson’s) Syndrome. Brit. J. Anaesth.,57, 1–4 (1979).
Edwards, G., Morton, H.J.V., Pask, E.A. &Wylie, W. D. Deaths associated with anaesthesia: a report of 1000 cases. Anaesthesia,11, 194–220 (1956).
Engel, T.R. &Luck, J.C. Histamine2 receptor antagonism by cimetidine and sinus node function. N. Engl. J. Med.,301, 591–592 (1979).
Flinkelstein, W. &Isselbacher, K.J. Cimetidine. N. Engl. J. Med.299, 992–996 (1978).
Fischer, M.W., Lorenz, W., Neugebauer, E. &Schmal, A. Histamine release and pathogenesis of stress ulcer in polytraumatized patients: a prospective randomized study on prophylactic effect of cimetidine. Zeitblatt Chir.104, 810 (1979).
Gibbs, C.P., Schwarts, D.J., Wynne, J.W., Hood, C.I. &Kuck, E.J. Antacid pulmonary aspiration in the dog. Anesthesiology,51, 380–385 (1979).
Giesecke, A.H., Beyer, C.W. &Kallus, F.T. More on interpretation of pH data. Anesth. Anal.,57, 379–381 (1978).
Giesecke, A.H. Averaging values for gastric pH incorrect. Anesthesiology,50,70–71 (1979).
Giesecke, A.H. Averaging pH vs H+ values. Anesthesiology,51, 481–483 (1979).
Grave, W., Nadorp, J.H.S.M. &Rutten, J.J.M.H. Cimetidine and renal failure. Lancet.,ii, 719–720 (1977).
Heaney, G.A. &Jones, H.D. Aspiration Syndromes in pregnancy. Brit. J. Anaesth.,51, 266–267 (1979).
Hester, J.B. &Heath, M.L. Pulmonary acid aspiration Syndrome: Should prophylaxis be routine? Brit. J. Anaesth.49, 595–599 (1977).
Hirasuna, J.D., Shelub, I. &Bolt, R.J. Hyper- histaminemia and peptic ulcer. West J. Med.131, 140–143 (1979).
Hurwitz, A., Robinson, R.G. &Vats, T.S. Effects of antacids on gastric emptying. Gastroenterology,71, 268–273 (1976).
Husemeyer, R.P., Davenport, H.T. &Rajasekaran, T. Cimetidine as a single oral dose for prophylaxis against Mendelson’s Syndrome. Anaesthesia,33, 775–778 (1978).
Jefferys, D.B. &Vale, J.A. Cimetidine and bradycardia. Lanceti, 828 (1978).
Keating, P.J., Black, J.F. &Waston, D.W. Effects of glycopyrrolate and cimetidine on gastric volume and acidity in patients awaiting surgery. Brit. J. Anaesth.,50, 1247–1250 (1978).
Klotz, U. &Reimann, I. Delayed clearance of diazepam due to cimetidine. N. Engl. J. Med.,302, 1012–1014 (1980).
Ligumsky, M., Shochina, M. &Rachmilewitz, D. Cimetidine and arrhythmia suppression. Ann. Intern. Med.,89, 1008–1009 (1978).
Lorenz, W., Doenicke, A., Neugebauer, E., Schwarz, B., Schmal, A. &Schoning, B. Definition of histamine release in human subjects and experimental animals using plasma histamine determination in the whole individual. Agents and Actions,9, 35 (1979).
Luciano, J.J., Theodorov-Touchais, A.M. &Souteyrand, P. Cimetidine: Trouble du rythme cardiaque au cours d’un traitement. Nouv. Presse Med.,7, 4049 (1978).
Mahon, W.A. &Kolton, M. Hypotension after intravenous cimetidine. Lancet,i, 828 (1978).
Maliniak, K. &Vakil A.H. Pre-anesthetic cimetidine and gastric pH. Anesth. Anal.,58, 309–313 (1979).
Maura, G., Vaccari, A. &Timiras, P.S. Effects of chronic stress on the development of histamine enzymes. Agents and Actions,7, 437–442 (1977).
Misiewicz, J.J. Symposium on gastroesophageal reflux and its complications. Gut.,14, 233–237 (1973).
Reding, P., Devroede, C. &Barbier, P. Brady- cardia after cimetidine. Lancet, ii, (1977).
Samuel, I.O. &Dundee, J.W. Influence of cimetidine on cardio-vascular parameters in man. J. R. Sop. Med.,72, 898–901(1979).
Serlin, M.J. &Williams, J.R.B. Cimetidine interaction with oral anticoagulants in man. Lancet,ii, 317–319 (1979).
Stoelting, R.K. Gastric fluid pH in patients receiving cimetidine. Anesth. Anal.,57, 675–677 (1978).
Stoelting, R.K. Responses to atropine, glycopyrrolate and Riopan of gastric fluid pH and volume in adult patients. Anesthesiology,45, 367–369 (1978).
Taylor, G. &Pryse-Davies, J. The prophylactic use of antacids in the prevention of the acid pulmonary aspiration syndrome (Mendelson’s Syndrome). Lancet,i, 288–291 (1966).
Taylor, G. Acid pulmonary aspiration syndrome after antacids. Brit. J. Anaesth.,47, 615–616 (1975).
Teabaut. J.R. Aspiration of gastric contents: an experimental study. Am. J. Pathol.,25, 51–67 (1952).
Wartburton, Opie, L.H., Kennelly, B.M. &Muller, F. O. Does cimetidine alter the cardiac response to exercise and propranolo? S. Afr. Med. J.55, 1125–1127 (1979).
Weber, L.A. &Hirschman. C.A. Cimetidine for prophylaxis ofaspirationpneumonitis: Comparison of intramuscular and oral dosage schedules. Anesthesiology,51, S180 (1979).
Young, R. &Sun, D.C. Effect of glycopyrrolate on antral mobility, gastric emptying and intestinal transit. Ann. N.Y. Acad. Sci.,99, 174–178 (1962).
Zavecz, J.H. &Levi, R. Histamine-induced negative inotropism: mediation by H, receptors. J. Pharmacol. Exp. Ther.,206, 274–280 (1978).
Author information
Authors and Affiliations
Additional information
Tirés à part: Christian Conseiller — même adresse.
Rights and permissions
About this article
Cite this article
Riche, D., Conseiller, C., Coulbois, B. et al. Contrôle de l’acidité gastrique par la cimétidine donnée en prémédication avant l’anesthésie générale: efficacité et tolérance. Canad. Anaesth. Soc. J. 28, 442–449 (1981). https://doi.org/10.1007/BF03010353
Issue Date:
DOI: https://doi.org/10.1007/BF03010353