The use of CO₂ for pneumoperitoneum during laparoscopic surgery provokes a decrement in the gastric pH. Since the incidence rate of PONV increases after laparoscopic surgery, the possibility of lung aspiration of gastric juice with a low pH during a postanesthetic emergence may increase and this could be fatal for the patient. We conducted this study to determine the effects of esomeprazole premedication on inhibiting the decrement of the gastric pH during laparoscopic surgery.

40 adult patients with no underlying diseases were chosen and 20 patients each were grouped as C (the control group) and E (the esomeprazole group). In both group, 0.2 mg glycopyrrolate was given intramuscularly 30 minutes prior to the surgery. In group E, esomeprazole was given orally 2 hours prior to the surgery. The pH, PaCO₂, and P_ETCO₂ were measured via pH probe, an ABGA and an capnogram at preinsufflation and 15, 30 and 60 minutes after the CO₂ insufflation and right before CO₂ exhaustion (predeflation).

Comparing the measurements of the gastric pH between group E and group C, all the results showed a significant increase in group E (P < 0.05). The difference of the PaCO₂ and P_ETCO₂ in the two groups was not significance.

In contrast to the decrease in the gastric pH as the PaCO₂ and P_ETCO₂ increased in group C, the gastric pH in group E remained high until the end of the surgery despite the increase in the PaCO₂ and P_ETCO₂. Esomeprazole premedication seem to have an effect for inhibiting the gastric pH decrement regardless of the increase in the PaCO₂ and P_ETCO₂ during laparoscopic surgery.