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Liao KL, Wang HH, Yang LY, Hsu YF, Chou FH, Chu YC. Effectiveness of Chewing Gum on Nausea and Vomiting Following Postprocedure: A Systematic Review and Meta-Analysis. J Perianesth Nurs 2024; 39:417-424.e2. [PMID: 38206218 DOI: 10.1016/j.jopan.2023.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 08/05/2023] [Accepted: 08/30/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE This study aimed to evaluate the effectiveness of chewing gum in reducing postprocedure nausea and vomiting. DESIGN A systematic review and meta-analysis. METHODS A systematic literature search was performed on MEDLINE Complete, EMBASE, CINAHL, PubMed, Web of Science, Academic Search Complete, and Cochrane Library databases from their inception to October 2, 2022. Methodological quality was assessed using the revised Cochrane Risk of Bias 2.0 tool for randomized trials. A meta-analysis was performed using a fixed-effects model to calculate pooled effects with Review Manager 5.4.1. FINDINGS Twelve randomized trials encompassing 1,458 participants were pooled. The chewing gum intervention was effective in reducing vomiting (P = .007; risk ratio = 0.55; 95% Cl = 0.35-0.85), but not nausea (P = .14; risk ratio = 0.84; 95% Cl = 0.66-1.06). Thirty-minute sessions of gum chewing were significantly more effective in reducing vomiting than 15-minute sessions (P = .04; risk ratio = 0.31; 95% Cl = 0.1-0.93). CONCLUSIONS The results indicate that repeated gum chewing sessions of at least 30 minutes may act as a nonpharmacological intervention for reducing vomiting. However, further studies are necessary to determine the outcomes of chewing gum interventions.
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Affiliation(s)
- Kuei-Lin Liao
- College of Nursing, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Hsiu-Hung Wang
- College of Nursing, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Li-Yu Yang
- College of Nursing, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Yi-Fen Hsu
- College of Nursing, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Fan-Hao Chou
- College of Nursing, Kaohsiung Medical University, Kaohsiung City, Taiwan.
| | - Yi-Chin Chu
- College of Nursing, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of nursing, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Chen X, Chang C, Yuan X, Yang J, Li K. Efficacy and safety of preoperative chewing gum for undergoing elective surgery: A meta-analysis of randomised controlled trials. J Clin Nurs 2023; 32:4295-4310. [PMID: 36691328 DOI: 10.1111/jocn.16604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/07/2022] [Accepted: 12/05/2022] [Indexed: 01/25/2023]
Abstract
AIMS AND OBJECTIVES This meta-analysis aimed to investigate the safety and feasibility of preoperative chewing gum in adult patients undergoing elective surgery. BACKGROUND Postoperative chewing gum has been shown to be safe and effective for most surgeries, while the safety and efficacy of preoperative chewing gum are still controversial. DESIGN A meta-analysis of randomised controlled trials was performed. NO PATIENT OR PUBLIC CONTRIBUTION This was a meta-analysis involving no people or animals. METHODS The literature search was performed in 9 databases from inception to July 2022. Randomised controlled trials that compared the safety and efficacy of preoperative chewing gum and preoperative chewing no gum in adult patients undergoing elective surgery were included. The study was reported in compliance with PRISMA statement. TRIAL REGISTRATION PROSPERO CRD42022330223. RESULTS Fourteen trials involving 1433 adult patients who undergo elective surgery were pooled in this meta-analysis. The results showed that preoperative chewing gum group resulted in no significant difference in gastric pH (p = .13) and gastric fluid volume (p = .25) compared with non-gum-chewing group. In comparison with the non-gum-chewing group, the gum-chewing group was associated with shorter preoperative thirst score (p = .02), lower incidence of postoperative nausea (p = .0004), lower incidence of postoperative sore throat, lower incidence of postoperative hoarseness, lower postoperative pain score, shorter first postoperative anal exhaust time (p < .00001), shorter first postoperative defecation time (p < .00001) and shorter hospital days (p = .02). CONCLUSIONS Preoperative chewing gum was associated with lower discomforts and complication rates, without increasing gastric pH and gastric fluid volume. This strategy may be an innovative, feasible and safe choice for elective surgery in adults. RELEVANCE TO CLINICAL PRACTICE This study's results could be used as an evidence for the implementation of preoperative chewing gum in perioperative care for adult patients undergoing elective surgery.
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Affiliation(s)
- Xinrong Chen
- West China School of Nursing /West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Chengting Chang
- West China School of Nursing /West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Xingzhu Yuan
- West China School of Nursing /West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Jie Yang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Ka Li
- West China School of Nursing /West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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Aboshama RA, Taha OT, Abdel Halim HW, Elrehim EIA, Kamal SHM, ElSherbiny AM, Magdy HA, Albayadi E, Elsaid RE, Abdelghany AM, Anan MA, Abdelfattah LE. Prevalence and risk factor of postoperative adhesions following repeated cesarean section: A prospective cohort study. Int J Gynaecol Obstet 2023; 161:234-240. [PMID: 36200671 DOI: 10.1002/ijgo.14498] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/12/2022] [Accepted: 10/03/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To evaluate the prevalence of intraperitoneal adhesions after repeated cesarean delivery and its associated personal and surgical risk factors. METHODS This prospective cohort study was conducted at the delivery ward at Fayoum University Hospital from October 2020 to December 2021. Women were recruited according to predetermined inclusion and exclusion criteria. Eligible women were interviewed, and data were obtained for personal history, past surgical and obstetrical history, and data about the current delivery. Nair's scoring system was used to evaluate intraperitoneal adhesions. Postoperative data and complications were reported. RESULTS Three hundred women were recruited. Moderate to severe adhesions occurred in 186 patients (62%). These patients had a significantly prolonged hospital stay and were delivered by expert surgeons (P < 0.001 and P = 0.008, respectively). The adhesion score correlated positively with patients' age (P < 0.001), parity (P < 0.001), interpregnancy interval (P = 0.033), duration of hospital admission either previously or in the current delivery (P = 0.001 and P < 0.001), time to ambulation (P < 0.001), time to intestinal movement (P < 0.001), operative time (P < 0.001), and surgeons' age and experience (both P = 0.015). CONCLUSION Adhesions led to increased maternal morbidity. Multiple contributing factors were significantly related to adhesions with multiple cesarean deliveries.
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Affiliation(s)
| | - Omima T Taha
- Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Hala Waheed Abdel Halim
- Department of Obstetrics and Gynecology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Eman Ibrahim Abd Elrehim
- Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | | | | | - Hagar Abdelgawad Magdy
- Department of Obstetrics and Gynecology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Eslam Albayadi
- Department of Anesthesia, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Rasha Ezzat Elsaid
- Department of Obstetrics and Gynecology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Amany Mohamed Abdelghany
- Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed A Anan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Laila Ezzat Abdelfattah
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
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Effects of Gum Chewing on Recovery From Postoperative Ileus: A Randomized Clinical Trail. THE JOURNAL OF NURSING RESEARCH : JNR 2022; 30:e233. [PMID: 35951432 DOI: 10.1097/jnr.0000000000000510] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Sham feeding with products such as chewing gum has been theorized to decrease the incidence and time to resolution of postoperative ileus. The conflicting findings in the literature on this subject are because in part of the use of mixed study populations, which has led to difficulties in assessing the value of sham feeding in ameliorating this condition. PURPOSE The aim of this study was to evaluate the efficacy of postsurgical gum chewing in restoring normal bowel movement in patients with colorectal cancer who had undergone abdominal surgery for colon resection. METHODS A randomized controlled trial was used to examine the time to first postoperative flatus and defecation. The intervention group ( n = 30) received xylitol chewing gum on the first day after colon resection, one piece of gum for 15 minutes, 3 times daily, until the time to first flatus and defecation. Both the intervention and control groups ( n = 30) received standard postoperative care and were encouraged to walk as soon as possible after surgery. The time to first flatus was reported by patients. RESULTS The time to first flatus and defecation in the intervention group was significantly shorter than that in the control group (39.13 ± 15.66 vs. 52.92 ± 21.97 hours and 54.55 ± 18.90 vs. 77.98 ± 34.59 hours, respectively). However, after controlling for age and surgical duration, only time to first flatus was significantly shorter in the intervention group. Significantly positive correlations were found between time to first flatus and time to first defecation in both groups. CONCLUSIONS/IMPLICATIONS FOR PRACTICE In this study, gum chewing was shown to have a positive effect on the time to first postoperative flatus and defecation. This inexpensive and noninvasive intervention may be recommended to decrease the time to resolution of postsurgical ileus in middle-aged and older patients who have undergone open abdominal surgery for colorectal resection.
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Elkan Kiyat Z, Kahyaoglu Sut H. The Effect of Xylitol Gum Chewing After Cesarean on Bowel Functions: A Randomized Controlled Study. J Perianesth Nurs 2022; 37:913-917. [PMID: 35750598 DOI: 10.1016/j.jopan.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/06/2022] [Accepted: 03/17/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Postoperative ileus after cesarean is a common complication. The delay of bowel functions after cesarean influences early parenthood experience, increases the need for analgesic use, extends the duration of hospital stay, and causes cost increase. This study aimed to explore the effect of xylitol gum chewing after cesarean on bowel functions. DESIGN A prospective randomized controlled trial was conducted on subjects immediately after second hour of the cesarean in a ward of maternity. METHODS A total of 69 women were randomized to the xylitol gum chewing group (n = 23), the nonxylitol gum chewing group (n = 23), or the control group (n = 23). Data were collected from the women who agreed to participate and met the inclusion criteria. Starting with the second hour after the cesarean, women in the xylitol and nonxylitol gum chewing group were asked to chew gum for 15 minutes every 2 hours. The practice of chewing gum minimum of 8 hours and a maximum of 12 hours continued (until midnight). The data regarding the first times for bowel sounds, flatulation, defecation, a feeling of hunger, and length of hospital stay were compared. FINDINGS There is no difference in starting time of first bowel sounds (P = .070) and the first feeling of hunger (P = .098) among the groups. The first flatulation started at an earlier time in the xylitol gum chewing group than the control group (17.35 ± 6.27 vs 11.18 ± 5.39 hours, P = .003); first defecation time started earlier in the xylitol gum chewing group than nonxylitol gum chewing group (44.05 ± 9.4 vs 37.58 ± 9.96 hours, P = .022). Xylitol gum chewing group (51.77 ± 10.3 vs 46.33 ± 8.11 hours, P = .028) and nonxylitol gum chewing group (51.77 ± 10.3 vs 50.23 ± 5.72 hours, P = .024) were discharged from the hospital earlier than control group. CONCLUSIONS In nursing care after cesarean, early period xylitol gum chewing is an efficient and user-friendly method to prompt bowel functions earlier. Xylitol gum chewing in nursing care is suggested to be involved.
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Affiliation(s)
- Zeliha Elkan Kiyat
- Trakya University, Institute of Health Sciences, Department Nursing, Edirne, Merkez, Turkey
| | - Hatice Kahyaoglu Sut
- Trakya University, Faculty of Health Sciences, Department of Women Health and Disease Nursing, Edirne, Merkez, Turkey.
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Bang YJ, Lee JH, Kim CS, Lee YY, Min JJ. Anxiolytic effects of chewing gum during preoperative fasting and patient-centered outcome in female patients undergoing elective gynecologic surgery: randomized controlled study. Sci Rep 2022; 12:4165. [PMID: 35264684 PMCID: PMC8907183 DOI: 10.1038/s41598-022-07942-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 01/06/2022] [Indexed: 11/09/2022] Open
Abstract
Although previous studies reported that chewing gum during the preoperative fasting has the benefits of alleviating anxiety and dry mouth, preoperative chewing gum has yet to be accepted as a standard practice due to conventional anesthetic custom. Our study aimed to prospectively evaluate the effects of gum chewing on preoperative anxiety and patient's discomfort in female patients undergoing gynecologic surgery. Ninety-four patients were enrolled and randomized either into conventional fasting group (control group) or chewing gum with fasting group (gum group). The control group was instructed to fast from 3 p.m. on the day before surgery. The gum group performed preoperative fasting in the same manner, but was encouraged to chew gum freely during the fasting period. The primary endpoint was the degree of preoperative anxiety. For the evaluation of preoperative anxiety, Amsterdam preoperative anxiety and information scale (APAIS) was used. Preoperative gastric fluid volume and acidity were also measured as the secondary outcomes. Preoperative anxiety using APAIS was significantly lower in the gum group compared to the control group (control group vs. gum group: 20.9 vs. 17.8, p = 0.009). However, there was no significant difference in the gastric fluid analysis between the groups. In the female patients for elective gynecologic surgery, chewing gum during the preoperative fasting period helped to alleviate preoperative anxiety without additional increase of pulmonary aspiration risks.Trial registration: KCT0004422 (05/11/2019, https://cris.nih.go.kr ; registration number).
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Affiliation(s)
- Yu Jeong Bang
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Jong-Hwan Lee
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Chung Su Kim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Yoo-Young Lee
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong-Jin Min
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea.
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Çintesun E, Kebapçılar AG, Uçar MG, Yılmaz SA, Bertizlioğlu M, Çelik Ç, Seçilmiş Kerimoğlu Ö. Effect of Closure of Anterior Abdominal Wall Layers on Early Postoperative Findings at Cesarean Section: A Prospective Cross-sectional Study. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2021; 43:250-255. [PMID: 33784761 PMCID: PMC10183910 DOI: 10.1055/s-0041-1726057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE To investigate the effect of closure types of the anterior abdominal wall layers in cesarean section (CS) surgery on early postoperative findings. METHODS The present study was designed as a prospective cross-sectional study and was conducted at a university hospital between October 2018 and February 2019. A total of 180 patients who underwent CS for various reasons were enrolled in the study. Each patient was randomly assigned to one of three groups: Both parietal peritoneum and rectus abdominis muscle left open (group 1), parietal peritoneum closure only (group 2), and closure of the parietal peritoneum and reapproximation of rectus muscle (group 3). All patients were compared in terms of postoperative pain scores (while lying down and during mobilization), analgesia requirement, and return of bowel motility. RESULTS The postoperative pain scores were similar at the 2nd, 6th, 12th, and 18th hours while lying down. During mobilization, the postoperative pain scores at 6 and 12 hours were significantly higher in group 2 than in group 3. Diclofenac use was significantly higher in patients in group 1 than in those in group 2. Meperidine requirements were similar among the groups. There was no difference between the groups' first flatus and stool passage times. CONCLUSION In the group with only parietal peritoneum closure, the pain scores at the 6th and 12th hours were higher. Rectus abdominis muscle reapproximations were found not to increase the pain score. The closure of the anterior abdominal wall had no effect on the return of bowel motility.
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Affiliation(s)
- Ersin Çintesun
- Department of Obstetrics and Gynecology, Selçuk University Medicine Faculty, Selçuklu, Konya, Turkey
| | - Ayşe Gül Kebapçılar
- Department of Obstetrics and Gynecology, Selçuk University Medicine Faculty, Selçuklu, Konya, Turkey
| | - Mustafa Gazi Uçar
- Department of Obstetrics and Gynecology, Selçuk University Medicine Faculty, Selçuklu, Konya, Turkey
| | - Setenay Arzu Yılmaz
- Department of Obstetrics and Gynecology, Selçuk University Medicine Faculty, Selçuklu, Konya, Turkey
| | - Mete Bertizlioğlu
- Department of Obstetrics and Gynecology, Selçuk University Medicine Faculty, Selçuklu, Konya, Turkey
| | - Çetin Çelik
- Department of Obstetrics and Gynecology, Selçuk University Medicine Faculty, Selçuklu, Konya, Turkey
| | - Özlem Seçilmiş Kerimoğlu
- Department of Obstetrics and Gynecology, Selçuk University Medicine Faculty, Selçuklu, Konya, Turkey
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