Sugarless gum chewing before surgery does not increase gastric fluid volume or acidity. 1994

S A Dubin, and H G Jense, and J M McCranie, and V Zubar
Department of Anesthesiology, Medical College of Georgia, Augusta 30912.

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. Thirty-one 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.

UI MeSH Term Description Entries
D008297 Male Males
D002638 Chewing Gum A preparation of chicle, sometimes mixed with other plastic substances, sweetened and flavored. It is masticated usually for pleasure as a candy substitute but it sometimes acts as a vehicle for the administration of medication. Chewing Gums,Gum, Chewing,Gums, Chewing
D005215 Fasting Abstaining from FOOD. Hunger Strike,Hunger Strikes,Strike, Hunger,Strikes, Hunger
D005260 Female Females
D005744 Gastric Acid Hydrochloric acid present in GASTRIC JUICE. Hydrochloric Acid, Gastric,Acids, Gastric,Acids, Gastric Hydrochloric,Gastric Acids,Gastric Hydrochloric Acid,Gastric Hydrochloric Acids,Hydrochloric Acids, Gastric
D005750 Gastric Juice The liquid secretion of the stomach mucosa consisting of hydrochloric acid (GASTRIC ACID); PEPSINOGENS; INTRINSIC FACTOR; GASTRIN; MUCUS; and the bicarbonate ion (BICARBONATES). (From Best & Taylor's Physiological Basis of Medical Practice, 12th ed, p651) Gastric Juices,Juice, Gastric,Juices, Gastric
D005766 Gastrointestinal Contents The contents included in all or any segment of the GASTROINTESTINAL TRACT. Digestive Tract Contents,Intestinal Contents,Stomach Contents,GI Contents,Digestive Tract Content,GI Content,Gastrointestinal Content,Intestinal Content,Stomach Content
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006863 Hydrogen-Ion Concentration The normality of a solution with respect to HYDROGEN ions; H+. It is related to acidity measurements in most cases by pH pH,Concentration, Hydrogen-Ion,Concentrations, Hydrogen-Ion,Hydrogen Ion Concentration,Hydrogen-Ion Concentrations
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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