Antacid Prophylaxis

Selected Guideline Examples Date
Radbourne Mid Yorkshire March 2013
Wider Scope
General Points
  • Recognition of the need for use of anatacid prophylaxis in mothers at high risk of requiring intervention
  • Most units appear to use Ranitidine as the drug of choice for antacid prophylaxis although Lanzoprazole used in one
  • Sodium citrate used for prophylaxis just before the section for GA cases although some also use for routine elective cases
  • Metochlopramide is used in some units to promote gastric emptying
We Liked
  • Background information on the background for need for antacid prophylaxis (Radbourne)
  • References at the end of the guideline so that the reader can explore the topic in greater detail if they so desire
  • Distinction between emergency and elective procedures
  • Concise, clear style of presentation, in a single page format
  • Instructions on how dilution of Ranitidine IV
  • Recognition of need to give IV prophylaxis in emergency situation and that oral medication requires to be given 1 hour in advance of procedure
  • Checking of pH from orogastric tube aspiration to determine need of further dose Na Citrate ( Radbourne)
We Didn't Like
Not Sure
  • Ranitidine 300mg used in one unit
  • Use of Lansaprozole (Radbourne)
Other
  • A background explanation is useful for trainees to understand the concepts behind the guidelines
  • Frequency of Ranitidine use in labour-varies between 6-8 hourly. while others advocate it 8 hourly
  • Difficult to always predict high risk women – low risk/ cost of giving antacid prophylaxis so should probably give to all women on an obstetric / high risk unit rather than a long list of inclusions
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