Assessing the effect of sugar-free chewing gum use on the residual gastric volume of patients fasting for gastroscopy: A randomised controlled trial

2023 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting: Carbohydrate-containing Clear Liquids with or without Protein, Chewing Gum, and Pediatric Fasting Duration-A Modular Update of the 2017 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting

These practice guidelines are a modular update of the "Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: Application to healthy patients undergoing elective procedures." The guidance focuses on topics not addressed in the previous guideline: ingestion of carbohydrate-containing clear liquids with or without protein, chewing gum, and pediatric fasting duration.

Hard-Candy Consumption Does Not Have an Effect on Volume and pH of Gastric Content in Patients Undergoing Elective Gastrointestinal Endoscopic Procedures: A Randomized Controlled Trial

Purpose

This study aimed to determine the effect of hard candies on gastric content volume and pH in patients undergoing elective esophagogastroduodenoscopy and colonoscopy. Additionally, the study evaluated the difficulty of the procedure, complications, and satisfaction levels of the endoscopist and patient.

Patients and Methods

A randomized controlled study equally recruited 108 outpatients to candy and control groups. The patients in the candy group could consume sugar-free candies within 2 hours before anesthesia, while the controls remained fasted. The endoscopic procedure began under topical pharyngeal anesthesia and intravenous sedation. A blinded endoscopist suctioned the gastric volume through an endoscope. A blinded anesthesia provider tested the gastric pH with a pH meter. The primary outcome variables were gastric volume and pH. The secondary outcome variables were complications, the difficulty of the procedure, and endoscopist and patient satisfaction.

Results

The characteristics of both patient groups were comparable. The mean gastric volume of the candy group (0.43 [0.27-0.67] mL/kg) was not significantly different from that of the control group (0.32 [0.19-0.55] mL/kg). The gastric pH of both groups was similar: 1.40 (1.10-1.70) for the candy group and 1.40 (1.20-1.90) for the control group. The procedure-difficulty score of the candy group was higher than that of the control group. The satisfaction scores rated by the endoscopist and the patients in both groups were comparable. In addition, most endoscopists and patients in the candy and control groups reported being "very satisfied". No complications were observed in either group.

Conclusion

Hard candies did not affect gastric volume or pH. Elective gastrointestinal endoscopic procedures in adult patients who preoperatively consume candies could proceed to prevent delays and disruption of workflows.

The effect of aromatherapy with peppermint essential oil on nausea and vomiting after cardiac surgery: A randomized clinical trial

Background Postoperative nausea and vomiting are common in patients who underwent cardiac surgery. This study aimed to examine the effect of peppermint essential oil inhalation on the postoperative nausea and vomiting after cardiac surgery. Methods In this clinical trial study, 60 cardiac surgery patients were divided into control and intervention groups. The intervention group underwent nebulizer aromatherapy with peppermint essential oil before the endotracheal tube was removed after surgery. Patients' nausea and vomiting were then assessed through a checklist. The independent-samples t-test, chi-square, and Generalized estimating equation were used for data analysis. Results Totally 85.7% of the patients undergone coronary artery bypass graft surgery. The two groups did not significantly differ in terms of their baseline demographic and clinical variables (P > 0.05). Significant differences were found between the intervention and control groups in terms of the frequency of nausea (0.63 ± 0.81 vs. 1.46 ± 1.21), its duration (3.78 ± 5.09 vs. 7.97 ± 5.55 min), and severity (2.43 ± 2.84 vs. 4.61 ± 2.85), and in the frequency of vomiting episodes (0.17 ±.46 vs. 0.73 ±.60) in the first four hours after extubation (P < 0.05). Conclusion: Peppermint essential oil inhalation has beneficial effects on reducing nausea and vomiting after open-heart surgery. Using peppermint essential oil inhalation for managing postoperative nausea and vomiting is recommended.