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Hans Jorgen Nielsen, MD; Henrik Nielsen, MD, DMSc; Soren Jensen, MD; Flemming Moesgaard, MD, DMSc

Arch Surg. 1994;129(3):309-315.

Abstract
Background
The histamine H2-receptor antagonist ranitidine hydrochloride has been shown to improve trauma-, blood transfusion–, and sepsis-induced immunosuppression.

Objective
To evaluate the effect of ranitidine on postoperative impairment in monocyte and neutrophil function.

Methods
Twenty-four patients undergoing major elective abdominal surgery were randomized to receive adjuvant treatment with ranitidine hydrochloride (100 mg) administered twice a day intravenously from skin incision for 4 days, followed by oral ranitidine hydrochloride (150 mg) administered twice a day for 5 days (n=11), or no adjuvant treatment (n=13). Blood monocyte and neutrophil chemotaxis and chemiluminescence were analyzed before the operation and on postoperative days 1, 3, and 9.

Results
Monocyte chemotaxis to C5a in the 13 control patients was significantly decreased on day 1 compared with day 0. Chemotaxis in the 11 ranitidine-treated patients increased significantly from day 0 to day 1 (P<.01 between groups). Neutrophil chemiluminescence to zymosan and N-f-methionyl-leucyl-phenylalanine was significantly increased in control patients on day 1 compared with day 0 (P<.05), while ranitidine reduced chemiluminescence to zymosan insignificantly on day 1 (P<.07 between groups). Five of the 13 control patients developed postoperative infectious complications, which were related to decreased monocyte chemotaxis to C5a and increased neutrophil chemiluminescence to zymosan, compared with noninfected patients. A significant difference (P<.05) in chemiluminescence to zymosan between infected and noninfected control patients was observed on day 3 before clinical signs of infectious disease could be detected. There were no infectious complications in ranitidine-treated patients.

Conclusion
These results support previous studies on the effect of ranitidine to improve postoperative immunosuppression.

(Arch Surg. 1994;129:309-315)

Author Affiliations
From the Department of Surgical Gastroenterology 235 (Drs H. J. Nielsen and Moesgaard), Surgical Immunology Laboratory 436 (Dr H. J. Nielsen), Hvidovre (Denmark) University Hospital; the Department of Microbiology, State University Hospital (Dr H. Nielsen); and the Department of Surgical Gastroenterology F, Bispebjerg University Hospital (Dr Jensen), Copenhagen, Denmark.

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