Effect of Gum Chewing on Pain and Anxiety in Turkish Children During Intravenous Cannulation: A Randomized Controlled Study

Topçu, Sacide Yıldızeli; Kostak, Melahat Akgün; Semerci, Remziye; Güray, Özlem

doi:10.1016/j.pedn.2019.12.007

Cited by 12 publications

(6 citation statements)

References 32 publications

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“…Although the anxiolytic effect of gum chewing was not confirmed, the fact that gum chewing was associated with a lower level of pain during CSE induction in cesarean section is noteworthy. This is consistent with previous studies that chewing gum may relieve labor pain (22) or procedural pain in medical experiences (23)(24)(25). For surgical patients, higher anxiety is associated with severe pain and increased analgesic requirements (26,27).…”

Section: Discussionsupporting

confidence: 91%

Effect of chewing gum on anxiety in women undergoing elective cesarean section: a randomized controlled study

Bang¹,

Lee²,

Kang³

et al. 2023

Ann Palliat Med

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Background: Preoperative anxiety is a common problem in pregnant women undergoing elective cesarean section. We aimed to determine the anxiolytic effects of chewing gum in pregnant women undergoing elective cesarean section under regional anesthesia.Methods: This was a single-center, prospective, randomized controlled trial. Sixty-six women were randomly assigned to either the control group (n=33) or gum group (n=33) in a 1:1 ratio. In the gum group, the participants chewed xylitol gum for at least 10 min/h, regardless of fasting. Gum chewing was started at 5 pm a day before surgery and continued till the participant entered the operation room. In the control group, participants were requested to follow fasting guidelines without further instruction. The primary outcome was preoperative anxiety measured using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) immediately before surgery. Results:The APAIS score immediately before surgery showed no significant difference between the control and the gum group (19.2±5.8 vs. 19.1±4.1, P>0.99). There were no statistically significant differences in the eight items related to anxiety: unfitness, concentration difficulty, hunger, thirst, dry mouth, fatigue, headache, and nausea. However, the pain score during the procedure of combined spinal epidural anesthesia was significantly lower in the chewing gum group [4 (IQR, 3-5.5)] than in the control group [5 (IQR, 3-7), P=0.045].Conclusions: Preoperative gum chewing did not reduce anxiety levels measured immediately before entering the operating room in the participants undergoing elective cesarean section.Trial Registration: Clinical Trial Registry of Korea; https://cris.nih.go.kr/cris/index.jsp and identifier: KCT0006602; date of registration: September 27, 2021; principal investigator's name: RyungA Kang).

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Section: Discussionsupporting

confidence: 91%

Effect of chewing gum on anxiety in women undergoing elective cesarean section: a randomized controlled study

Bang¹,

Lee²,

Kang³

et al. 2023

Ann Palliat Med

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“…Mastication and sham feeding in stressful situations have been shown to decrease levels of plasma cortisol and stress-related substances including neurotrophic factors, through the modulation of the hypothalamic–pituitary–adrenal axis and autonomic nervous system, especially in humans with acute stress 27 – 30 . In particular, chewing gum increases attentiveness, improves mood, and reduces stress and anxiety 28 , 31 – 33 . It is thought that chewing gum during the preoperative period may relieve emotional tension or stress, resulting in lower preoperative anxiety levels.…”

Section: Discussionmentioning

confidence: 99%

Anxiolytic effects of chewing gum during preoperative fasting and patient-centered outcome in female patients undergoing elective gynecologic surgery: randomized controlled study

Bang

Lee

Kim

et al. 2022

Sci Rep

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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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“…Among them, the possible mechanism of the role of gum: first, the active components in gum such as mint and xylitol have anti‐inflammatory and antibacterial effects, which may prevent pharyngeal complications (Tapiainen et al, 2002); Second, the gum stimulates the secretion of saliva, lubricates the oropharynx, reduces mechanical damage and has antibacterial effect; Moreover, the saliva secreted can also activate the plasma coagulation system, limit the spread of bacteria and reduce further damage to the oropharynx (Wollein Waldetoft et al, 2016). In addition, some studies also found that chewing gum can alleviate the anxiety and depression of patients, and the mechanism may be related to chewing gum increasing the concentration of synaptic serotonin neurotransmitters in neurons (Yaman‐Sözbir et al, 2019; Yildizeli Topcu, et al, 2020). Meanwhile, preoperative chewing gum may reduce short‐term postoperative pain, which may be because the activation of sympathetic nerve is related to the generation of pain.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of preoperative chewing gum for undergoing elective surgery: A meta‐analysis of randomised controlled trials

Chen

Chang

Yuan

et al. 2023

Journal of Clinical Nursing

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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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Effect of Gum Chewing on Pain and Anxiety in Turkish Children During Intravenous Cannulation: A Randomized Controlled Study

Cited by 12 publications

References 32 publications

Effect of chewing gum on anxiety in women undergoing elective cesarean section: a randomized controlled study

Effect of chewing gum on anxiety in women undergoing elective cesarean section: a randomized controlled study

Anxiolytic effects of chewing gum during preoperative fasting and patient-centered outcome in female patients undergoing elective gynecologic surgery: randomized controlled study

Efficacy and safety of preoperative chewing gum for undergoing elective surgery: A meta‐analysis of randomised controlled trials

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