Cimetidine in anesthesia: does it minimize the complications of acid aspiration?

Drug Intelligence & Clinical Pharmacy
S F Kowalsky


The use of cimetidine, an H2-receptor antagonist, to minimize the complications of acid aspiration pneumonia is reviewed. Since Mendelson's early description of acid aspiration in 66 obstetrical patients, attempts have been made to decrease gastric acidity by administering perioperative antacids and/or antihistamine drugs such as atropine and glycopyrrolate. In this review of the literature, strict attention is given to study design and subject selection, methods of collecting gastric samples and reporting both pH and volume measurements, and medications taken on admission, given preoperatively, and as anesthetics. Clinical trials evaluating cimetidine alone and compared with other prophylactic regimens were reviewed, detailing the timing, route, and frequency of drug administration. Cimetidine appears to be effective in minimizing complications of acid aspiration since gastric acidity (pH less than 2.5) is a contributing factor in both the morbidity and mortality of this disease state. In general terms, cimetidine 300 mg po 1.5-2.0 h prior to intubation or 45-60 minutes iv before surgery will decrease gastric acidity below the critical level. This effect may be maintained for up to three hours. Perioperative cimetidine adminis...Continue Reading


Apr 8, 1976·The New England Journal of Medicine·G F LongstrethJ R Malagelada
Oct 1, 1978·Anaesthesia·R P HusemeyerT Rajasekaran
Dec 1, 1978·British Journal of Anaesthesia·P J KeatingD W Watson
May 1, 1979·Anesthesia and Analgesia·D W CoombsT Colton
Jul 1, 1979·Anesthesia and Analgesia·K Maliniak, A H Vakil
Oct 1, 1979·British Journal of Anaesthesia·G DobbJ G Williams
Oct 30, 1976·Lancet·W L BurlandM W Mills
Nov 18, 1978·Lancet·P Powell-JacksonT C Northfield
Feb 24, 1979·Lancet·G BodemarA Walan
Sep 29, 1979·Lancet·U KlotzT Reimann
May 1, 1975·British Journal of Anaesthesia·G Taylor
Oct 1, 1977·Annals of Internal Medicine·J W Wynne, J H Modell
Sep 24, 1977·British Medical Journal·F FrostV R Nissen
Apr 17, 1979·European Journal of Clinical Pharmacology·R LarssonB Norlander
Oct 1, 1975·Chest·J G Bartlett, S L Gorbach
Jan 1, 1973·Archives of Surgery·J L CameronG D Zuidema
Jul 1, 1974·The Annals of Thoracic Surgery·D K BoneJ L Cameron
Aug 1, 1971·Archives of Surgery·R T LewisL G Hampson
May 1, 1968·Anesthesiology·J H ModellT C Weibley
Jul 1, 1969·Annals of Surgery·L J GreenfieldJ J Coalson
Jul 1, 1967·Annals of Internal Medicine·J H ModellA V Showers
Aug 1, 1981·Lancet·J W DundeeW McCaughey
Nov 1, 1980·European Journal of Clinical Pharmacology·U Klotz, I Reimann
May 21, 1981·The New England Journal of Medicine·R R Schade, R M Donaldson
Jan 1, 1980·Acta Anaesthesiologica Scandinavica·P KirkegaardP Kirkegaard
Oct 1, 1980·Digestive Diseases and Sciences·R FiasseC Dive
Jan 1, 1982·Clinical Pharmacokinetics·A Somogyi, R Gugler
May 1, 1982·Annals of Emergency Medicine·D W CoombsM Pageau
Jan 1, 1982·Anaesthesia·J R JohnstonJ W Dundee
Aug 12, 1982·The New England Journal of Medicine·W M SteinbergD M Katz
Feb 1, 1981·Anaesthesia·W McCaugheyJ W Dundee
May 21, 1981·The New England Journal of Medicine·A E Cocco, D V Cocco
Jan 1, 1981·Canadian Anaesthetists' Society Journal·D W Coombs, D W Hooper
Apr 1, 1981·Anaesthesia·J P HoweJ W Dundee
Jun 1, 1981·Anaesthesia·J S Crawford
Jan 1, 1981·European Journal of Clinical Pharmacology·R GuglerA Somogyi
Jun 1, 1980·British Journal of Clinical Pharmacology·P A BjaeldagerE F Hvidberg
Jan 1, 1980·Anaesthesia·A Baraka, M Shamma'a
Aug 1, 1980·Annals of Internal Medicine·P V DesmondK V Speeg
Nov 1, 1980·Anaesthesia and Intensive Care·P J Barnes, J H Havill
Nov 1, 1954·Anesthesiology·W BERSON, J ADRIANI
Jul 1, 1956·Anaesthesia·G EDWARDSW D WYLIE
Mar 1, 1962·Anesthesiology·W K BANNISTER, A J SATTILARO
Apr 1, 1963·British Journal of Anaesthesia·B S CLIFTON, W I HOTTEN
Aug 1, 1946·American Journal of Obstetrics and Gynecology·C L MENDELSON


Mar 1, 1989·DICP : the Annals of Pharmacotherapy·E R Gonzalez, S K Kallar
Oct 4, 2006·Current Opinion in Anaesthesiology·Mark A Warner
Oct 5, 2006·Current Opinion in Anaesthesiology·Randall P FlickMark A Warner

Related Concepts

Biological Availability
Clinical Trials
Gastric Acid
Gastric Acidity Determination
Aspiration Pneumonia
Preanesthetic Medication

Trending Feeds


Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Synthetic Genetic Array Analysis

Synthetic genetic arrays allow the systematic examination of genetic interactions. Here is the latest research focusing on synthetic genetic arrays and their analyses.

Congenital Hyperinsulinism

Congenital hyperinsulinism is caused by genetic mutations resulting in excess insulin secretion from beta cells of the pancreas. Here is the latest research.

Neural Activity: Imaging

Imaging of neural activity in vivo has developed rapidly recently with the advancement of fluorescence microscopy, including new applications using miniaturized microscopes (miniscopes). This feed follows the progress in this growing field.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Epigenetic Memory

Epigenetic memory refers to the heritable genetic changes that are not explained by the DNA sequence. Find the latest research on epigenetic memory here.

Cell Atlas of the Human Eye

Constructing a cell atlas of the human eye will require transcriptomic and histologic analysis over the lifespan. This understanding will aid in the study of development and disease. Find the latest research pertaining to the Cell Atlas of the Human Eye here.

Femoral Neoplasms

Femoral Neoplasms are bone tumors that arise in the femur. Discover the latest research on femoral neoplasms here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.