Abstract
Patients occasionally arrive in the operating suite chewing gum despite instructions to avoid oral intake for a specific number of hours before surgery. Some anaesthetists are hesitant to proceed with these patients fearing an increase in gastric volume and acidity. This study was undertaken to determine if gum chewing increased gastric volume and acidity. Seventy seven patients were recruited and informed consent obtained. Thirtyone patients who fasted overnight were randomly assigned either to serve as control (Group 1) or to chew sugarless gum prior to anaesthesia (Group 2). The remaining 46 patients fasted overnight but were given sugarless gum and allowed to chew it until immediately before induction of anaesthesia if they desired (Group 3). Volume and pH of gastric content were determined immediately after induction of anaesthesia and tracheal intubation. Results revealed mean values (range) of gastric volume for Group 1 — 26 ml (9–60), Group 2 — 40 ml (5–93), and Group 3 — 28 ml (4–65). Mean values for pH (range) were Group 1 — 1.8 (1.0–4.6), Group 2 — 1.6 (1.3–1.9), Group 3 — 1.7 (1.0–4.4). There was no difference between groups in terms of gastric volume or pH. In addition, there was no relationship between gastric content and the length of time from gum discard to induction or the length of time gum was chewed. In conclusion, the data suggest that induction of anaesthesia is safe and surgery does not need to be delayed if a patient arrives in the OR chewing sugarless gum.
Résumé
Occasionnellement des patients arrivent à la salle d’opération en mâchant de la gomme contrairement à la consigne du jeûne absolu spécifié pour un nombre d’heures avant la chirurgie. Certains anesthésistes hésitent à anesthésier ces patients parce qu’ils redoutent l’augmentation du volume et de l’acidité gastriques. Cette étude vise à déterminer si la gomme à mâcher augmente le volume et l’acidité gastriques. Soixante-dix patients consentants sont inclus dans l’étude. Trente-et-un patients sont gardés à jeun pour la nuit et répartis au hasard soit pour servir de contrôle (groupe 1) ou pour mâcher de la gomme sans sucre avant l’anesthésie (groupe 2). Les quarante-six autres restent à jeun pendant toue le nuit mais ont la permission de mâcher de la gomme sans sucre jusqu’à l’induction de l’anesthésie s’ils le désirent (groupe 3). Le volume et le pH gastriques sont mesurés immédiatement après l’induction de l’anesthésie et l’intubation de la trachée. Les résultats révèlent les valeurs moyennes de volume gastrique (étendue des valeurs) suivantes: groupe 1 — 26 (9–60); groupe 2 — 40 (5–93), et groupe 3 — 28 (4–65). Les valeurs moyennes de pH (étendue des valeurs) sont pour le groupe 1 — 1,8 (1,0–4,6), groupe 2 — 1,6 (1,3–1,9), groupe 3 — 1,7 (1,0–4,4). On ne trouve pas de différence entre les groupes au regard du volume gastrique ou du pH. De plus, il n’y a pas de relation entre le contenu gastrique et l’intervalle compris entre l’abandon de la gomme à mâcher et l’induction ou le durée du mâchement. En conclusion, ces données suggèrent que l’induction de l’anesthésie n’est pas plus dangereuse et qu’on n’a pas à retarder la chirurgie si un patient arrive en salle d’opération en mâchant de la gomme sans sucre.
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Dubin, S.A., Jense, H.G., McCranie, J.M. et al. Sugarless gum chewing before surgery does not increase gastric fluid volume or acidity. Can J Anaesth 41, 603–606 (1994). https://doi.org/10.1007/BF03010000
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DOI: https://doi.org/10.1007/BF03010000