Anxiolytic Effects of Chewing Gum During Preoperative Fasting and Patient-centered Outcome in Female Patients Undergoing Elective Gynecologic Surgery: Randomized controlled study

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-three 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 endpoints were the degree of preoperative anxiety and discomfort immediately before surgery. 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 (17.8 vs. 20.9, p = 0.009). The APAIS sub-score of anxiety and information desire domain were also lower in the gum group. 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)