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British Journal of Anaesthesia, 2003, Vol. 90, No. 5 576-579
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia

Editorial II

Preanaesthetic H2 antagonists for acid aspiration pneumonia prophylaxis. Is there evidence of tolerance?

K. Hirota1 and T. Kushikata1

1 Department of Anesthesiology, University of Hirosaki, School of Medicine, Hirosaki 036-8562, Japan. E-mail: masuika@cc.hirosaki-u.ac.jp

The first 150 words of the full text of this article appear below.

Acid aspiration during induction of anaesthesia resulting in pneumonia is rare, with an incidence of about three per 10 000 general anaesthetics.1 2 However, this complication has a high morbidity and mortality. Rosenstock and colleagues3 reported patients’ complaints against anaesthetic and intensive care personnel made to a national board in Denmark between 1994 and 1998. Sixty of the complaints (20% of the total) were related to adverse respiratory events, for example equipment misuse, difficult intubation. Seven patients suffered from pulmonary aspiration of gastric contents, in this report, six of whom died. All the deaths occurred in patients who had been in a poor general condition before operation.

Economic constraints and the expansion of day care units have increased the number of surgical day-cases, but it has been reported that outpatients have a higher risk of aspiration pneumonia than inpatients, as outpatients often have a larger residual gastric volume.4 Prophylaxis against aspiration . . . [Full Text of this Article]

Regulation of gastric acid secretion

Evidence of tolerance to H2 antagonists

Mechanism of tolerance

Tolerance to H2 antagonists and anaesthetic practice

Proton pump inhibitors


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This article has been cited by other articles:


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 Anesth. Analg.Home page
K. Hirota, M. Kudo, H. Hashimoto, and T. Kushikata
The Efficacy of Preanesthetic Proton Pump Inhibitor Treatment for Patients on Long-Term H2 Antagonist Therapy
Anesth. Analg., October 1, 2005; 101(4): 1038 - 1041.
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 Br J AnaesthHome page
A. Timmins, K. Hirota, and T. Kushikata
Preanaesthetic H2 antagonists for acid aspiration pneumonia prophylaxis. Is there evidence of tolerance?
Br. J. Anaesth., September 1, 2003; 91(3): 446 - 447.
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