Effect of preoperative gum chewing on the patients’ rehabilitation after gynecologic laparoscopic surgery_West China Medical Journal

Authors：

HE Teng ¹ , LI Huafeng ¹ , GUO Jin ² ,  LUO Jinfeng ³

1. Department of Anesthesiology, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, P. R. China;
2. Department of Anesthesiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P. R. China;
3. Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

LUO Jinfeng, Email: 360905620@qq.com

Keywords：

Gum chewing; Gynecologic laparoscopic surgery; Postoperative rehabilitation; Postoperative gastrointestinal tract dysfunction; Postoperative pain

DOI：

10.7507/1002-0179.201903107

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the effect of preoperative gum chewing on the postoperative rehabilitation of patients undergoing gynecologic laparoscopic surgery.Methods A total of 160 patients undergoing elective gynecologic laparoscopic surgery between January and May 2013 were selected to participate in the study. Each patient was randomly assigned to one of the two groups: the trial group (n=80) or the control group (n=80). Thirty to sixty minutes before the surgery, the patients in the trial group chewed one piece of sugarless gum for at least 30 minutes, and then removed the gum before being taken to the operating room; while the patients in the control group chewed nothing. The time to first passage of flatus and the time to first defecation after surgery, length of hospital stay, the degrees of pain at 2-, 4-, 6-, 8-, 24-, 48-hour after surgery, the incidences of postoperative nausea, vomiting, and abdominal distension, postoperative analgesic and antiemetic drug requirement were recorded.Results The mean time to first passage of flatus was significantly earlier in the trial group than that in the control group [(16.49±7.64) vs. (20.25±7.94) hours, P=0.003]. The mean time to first defecation was significantly earlier in the trial group than that in the control group [(48.16±15.25) vs. (55.80±18.97) hours, P=0.006]. The degree of pain at 2-hour after surgery was significantly lighter in the trial group than that in the control group (P<0.05). Fewer participants in the trial group than in the control group experienced postoperative nausea (43.75% vs. 61.25%, P=0.027). There were no significant differences in the length of hospital stay, the degrees of pain at 4-, 6-, 8-, 24- and 48-hour after surgery, incidences of postoperative vomiting and abdominal distension, postoperative analgesic, or antiemetic drug requirement between the two groups (P>0.05).Conclusions Gum chewing before surgery can promote the recovery of gastrointestinal function, reduce postoperative short-term pain, and promote postoperative rehabilitation in patients undergoing gynecologic laparoscopic surgery. Gum chewing before surgery can be used clinically as an easy, inexpensive, safe, and effective procedure.

Citation： HE Teng, LI Huafeng, GUO Jin, LUO Jinfeng. Effect of preoperative gum chewing on the patients’ rehabilitation after gynecologic laparoscopic surgery. West China Medical Journal, 2019, 34(8): 917-920. doi: 10.7507/1002-0179.201903107 Copy

1.	Ledari FM, Barat S, Delavar MA. Chewing gums has stimulatory effects on bowel function in patients undergoing cesarean section: a randomized controlled trial. Bosn J Basic Med Sci, 2012, 12(4): 265-268.
2.	Jang SY, Ju EY, Kim DE, et al. First flatus time and xerostomia associated with gum-chewing after liver resection. J Clin Nurs, 2012, 21(15/16): 2188-2192.
3.	Bhatiyani B, Pandeeswari, Bhasani D, et al. Effect of chewing gum on the postoperative recovery of gastrointestinal function after gynaecological laparoscopic surgery. Int J Reprod Contracept Obstet Gynecol, 2018, 7(2): 644-647.
4.	Gong YH, Zhang QW, Qiao L, et al. Xylitol gum chewing to achieve early postoperative restoration of bowel motility after laparoscopic surgery. Surg Laparosc Endosc Percutan Tech, 2015, 25(4): 303-306.
5.	Husslein H, Franz M, Gutschi M, et al. Postoperative gum chewing after gynecologic laparoscopic surgery. Obstet Gynecol, 2013, 122(1): 85-90.
6.	Frederic S. 現代重癥監護診斷與治療. 4 版. 邱海波, 譯. 北京: 人民衛生出版社, 2003: 79.
7.	Poulton TJ. Gum chewing during pre-anesthetic fasting. Paediatr Anaesth, 2012, 22(3): 288-296.
8.	Berghmans TM, Hulsewe KW, Buurman WA, et al. Stimulation of the autonomic nervous system in colorectal surgery: a study protocol for a randomized controlled trial. Trials, 2012, 13(1): 93.
9.	楊廣清, 楊小梅, 伍春蘭, 等. 咀嚼口香糖對婦產科微創手術后病人胃腸功能的影響. 護理研究, 2011, 25(2): 311-312.
10.	Scholey A, Haskell C, Robertson B, et al. 咀嚼口香糖可緩解急性心理壓力產生的負性情緒并降低唾液皮質醇水平//第十二屆全國心理學學術大會論文摘要集. 北京: 中國心理學會, 2009: 713.
11.	Parnaby CN, Macdonald AJ, Jenkins JT. Sham feed or sham? A meta-analysis of randomized clinical trials assessing the effect of gum chewing on gut function after elective colorectal surgery. Int J Colorectal Dis, 2009, 24(5): 585-592.
12.	Jernigan AM, Chen CC, Sewell C. A randomized trial of chewing gum to prevent postoperative ileus after laparotomy for benign gynecologic surgery. Int J Gynecol Obstet, 2014, 127(3): 279-282.
13.	Dubin SA, Jense HG, McCranie JM, et al. Sugarless gum chewing before surgery does not increase gastric fluid volume or acidity. Can J Anaesth, 1994, 41(7): 603-606.
14.	Milov DE, Andres JM, Erhart NA, et al. Chewing gum bezoars of the gastrointestinal tract. Pediatrics, 1998, 102(2): e22.
15.	Thompson AG, Razak S, Jayasinghe R. Cardiac arrest and chewing gum-an unfortunate combination. Med J Aust, 2007, 187(11/12): 635.

1. Ledari FM, Barat S, Delavar MA. Chewing gums has stimulatory effects on bowel function in patients undergoing cesarean section: a randomized controlled trial. Bosn J Basic Med Sci, 2012, 12(4): 265-268.
2. Jang SY, Ju EY, Kim DE, et al. First flatus time and xerostomia associated with gum-chewing after liver resection. J Clin Nurs, 2012, 21(15/16): 2188-2192.
3. Bhatiyani B, Pandeeswari, Bhasani D, et al. Effect of chewing gum on the postoperative recovery of gastrointestinal function after gynaecological laparoscopic surgery. Int J Reprod Contracept Obstet Gynecol, 2018, 7(2): 644-647.
4. Gong YH, Zhang QW, Qiao L, et al. Xylitol gum chewing to achieve early postoperative restoration of bowel motility after laparoscopic surgery. Surg Laparosc Endosc Percutan Tech, 2015, 25(4): 303-306.
5. Husslein H, Franz M, Gutschi M, et al. Postoperative gum chewing after gynecologic laparoscopic surgery. Obstet Gynecol, 2013, 122(1): 85-90.
6. Frederic S. 現代重癥監護診斷與治療. 4 版. 邱海波, 譯. 北京: 人民衛生出版社, 2003: 79.
7. Poulton TJ. Gum chewing during pre-anesthetic fasting. Paediatr Anaesth, 2012, 22(3): 288-296.
8. Berghmans TM, Hulsewe KW, Buurman WA, et al. Stimulation of the autonomic nervous system in colorectal surgery: a study protocol for a randomized controlled trial. Trials, 2012, 13(1): 93.
9. 楊廣清, 楊小梅, 伍春蘭, 等. 咀嚼口香糖對婦產科微創手術后病人胃腸功能的影響. 護理研究, 2011, 25(2): 311-312.
10. Scholey A, Haskell C, Robertson B, et al. 咀嚼口香糖可緩解急性心理壓力產生的負性情緒并降低唾液皮質醇水平//第十二屆全國心理學學術大會論文摘要集. 北京: 中國心理學會, 2009: 713.
11. Parnaby CN, Macdonald AJ, Jenkins JT. Sham feed or sham? A meta-analysis of randomized clinical trials assessing the effect of gum chewing on gut function after elective colorectal surgery. Int J Colorectal Dis, 2009, 24(5): 585-592.
12. Jernigan AM, Chen CC, Sewell C. A randomized trial of chewing gum to prevent postoperative ileus after laparotomy for benign gynecologic surgery. Int J Gynecol Obstet, 2014, 127(3): 279-282.
13. Dubin SA, Jense HG, McCranie JM, et al. Sugarless gum chewing before surgery does not increase gastric fluid volume or acidity. Can J Anaesth, 1994, 41(7): 603-606.
14. Milov DE, Andres JM, Erhart NA, et al. Chewing gum bezoars of the gastrointestinal tract. Pediatrics, 1998, 102(2): e22.
15. Thompson AG, Razak S, Jayasinghe R. Cardiac arrest and chewing gum-an unfortunate combination. Med J Aust, 2007, 187(11/12): 635.

West China Medical Journal

Effect of preoperative gum chewing on the patients’ rehabilitation after gynecologic laparoscopic surgery

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