Abstract
Background: To explore the effect of single oral dose of esomeprazole 20 mg, administered a night before surgery, on intragastric pH and volume in adult patients undergoing elective surgery by excluding cases contaminated with duodenogastric refluxate.Patients and Methods: This prospective, triple blind, randomised and placebo controlled clinical trial was conducted to explore the effect of single oral dose of esomeprazole 20 mg, administered a night before surgery, on intragastric pH and volume on 120 adult inpatients of either sex, American Society of Anaesthesiologist physical status I-II, and aged 15–70 years. The patients in Group C (control) received placebo while Group E (Esomeprazole) received esomeprazole orally at 9.00 pm, the night before elective surgery.On the day of surgery, the gastric contents were aspirated with a large bore, multi-orifice gastric tube passed through an endotracheal tube placed blindly in the oesophagus after tracheal intubation and analysed for pH, volume and the presence of bile salts.Results: Thirty nine samples (33%) out of 117 were contaminated with duodenal contents. Duodenogastric reflux significantly affected pH and volume in Group C (p value 0.0003 and 0.0016) and E (p value 0.0401 and < 0.0001). Esomeprazole, after excluding samples contaminated with duodenal fluid, significantly increased pH (p 25 ml/kg) at the time of induction of anaesthesia excluding samples contaminated with duodenogastric reflux.