An Evaluation of the Comparative Efficacy of Preoperative Oral Omeprazole, Lansoprazole and Dexrabeprazole on Gastric Fluid pH and Volume in Patients undergoing Elective Surgery under General Anaesthesia

Background and Aims: Aspiration of gastric contents in the lungs is one of the most feared complications of anaesthesia. Although the incidence of this complication is very low, it has high morbidity and mortality. The present study was carried out to evaluate and compare the efficacy of omeprazole, lansoprazole, and dexrabeprazole in reducing gastric volume and increasing the fasting pH in patients undergoing elective surgery. Methods: After obtaining institutional approval and written informed consent from the patients, 150 patients of ASA physical status 1 and 2, between age 18-55 years undergoing elective surgery under general anaesthesia were included in the study. The patients were randomly assigned to one of the three groups i.e. omeprazole (20 mg) group, lansoprazole (30 mg) group or dexrabeprazole (10 mg) group. Comparison of fasting interval, pH, volume and volume/weight of the aspirate was done using Kolmogorov-Smirnov test and Student Newman-Keuls test. A p-value <0.05 was considered statistically significant. Results: The mean pH was significantly lower in omeprazole group as compared to other two groups. The volume of gastric aspirate was significantly higher (p-value <0.005) in omeprazole group than in dexrabeprazole and lansoprazole group. There was no significant difference in the pH and volume of gastric contents in lansoprazole and dexrabeprazole group. Conclusion: Newer proton pump inhibitors like dexrabeprazole and lansoprazole are better than omeprazole in controlling gastric fluid environment.