Usefulness of pre-operative oral administration of two consecutive doses, a night before and then in the morning, of omeprazole with domperidone, omeprazole alone, and control (placebo) in reducing the risk of aspiration of gastric contents

Objectives

Pulmonary aspiration of gastric contents remains a recognized perioperative complication that can result in significant morbidity during general anesthesia. Pharmacological strategies aimed at increasing gastric pH and reducing residual gastric volume are commonly employed to decrease aspiration risk. This study evaluated the effectiveness of two pre-operative doses of omeprazole alone or in combination with domperidone on gastric pH, gastric volume, and duodenogastric reflux in patients undergoing elective surgery. Materials and Methods: In this prospective, randomized, placebo-controlled clinical trial, 180 adult patients (American Society of Anesthesiologists physical status I–II), aged 15–70 years and scheduled for elective surgery under general anesthesia, were enrolled. Participants were allocated equally into three groups ( n = 60 each). Group OD received omeprazole 40 mg plus domperidone 10 mg, Group O received omeprazole 40 mg alone, and Group C received placebo. Study medications were administered orally at 9:00 p.m. on the evening before surgery and again at 6:00 a.m. on the day of surgery. Following induction of anesthesia and endotracheal intubation, gastric contents were aspirated through an orogastric tube. Gastric fluid volume and pH were measured, and the presence of bile was assessed using Hay’s sulfur test.