咀嚼口香糖对妇科手术患者术前焦虑评分的影响：一项随机对照研究。
The effect of adding chewing gum to oral carbohydrates on preoperative anxiety scores in women undergoing gynecological surgery: A randomized controlled study.
机构信息
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
出版信息
PLoS One. 2023 Apr 25;18(4):e0283780. doi: 10.1371/journal.pone.0283780. eCollection 2023.
BACKGROUND
Preoperative anxiety is an unpleasant experience that can adversely affect perioperative outcomes. Although clinical benefits of preoperative oral carbohydrate is well reported, the effect of adding chewing gum to carbohydrate loading has never been studied. We aimed to investigate the effect of adding gum-chewing to oral carbohydrates on preoperative anxiety and gastric volume in patients undergoing gynecologic surgery.
METHODS
One hundred and four patients were enrolled and randomized either into a carbohydrate drink group (CHD group) or CHD with gum group. The CHD group was instructed to drink 400 mL of oral carbohydrate the evening before and 200-400 mL 3 hours before surgery. The CHD with gum group was encouraged to chew gum freely during preanesthetic fasting in addition to consuming oral carbohydrates in the same manner. The primary endpoint was preoperative anxiety assessed using the Amsterdam preoperative anxiety and information scale (APAIS). The degree of patient-reported quality of recovery after surgery and gastric volume prior to general anesthesia were also compared as secondary outcomes.
RESULTS
Preoperative APAIS was lower in the CHD with gum group compared with the CHD group (16 [11.5, 20] vs. 20 [16.5, 23], p = 0.008). Patient-rated quality of recovery after surgery was also higher in the CHD with gum group and showed a significant negative correlation with preoperative APAIS score (correlation coefficient: -0.950, p = 0.001). Gastric volume were not different between the groups (0 [0-0.45] vs. 0 [0-0.22], p = 0.158).
CONCLUSION
The addition of gum chewing to oral carbohydrate loading during preoperative fasting was more effective in relieving preoperative anxiety than oral carbohydrate alone in women patients undergoing elective gynecologic surgery.
TRIAL REGISTRATION
Clinical Research Information Services, CRIS identifier: KCT0005714, https://cris.nih.go.kr/cris/index.jsp.
背景
术前焦虑是一种不愉快的体验，可对围手术期结果产生不利影响。虽然术前口服碳水化合物的临床益处已有充分报道，但从未研究过在碳水化合物负荷中添加咀嚼口香糖的效果。我们旨在研究在妇科手术患者中，在口服碳水化合物中添加咀嚼口香糖对术前焦虑和胃容量的影响。
方法
共纳入 104 例患者，并将其随机分为碳水化合物饮料组（CHD 组）或 CHD 加口香糖组。CHD 组被指示在手术前一天晚上饮用 400 mL 口服碳水化合物，手术前 3 小时内饮用 200-400 mL。CHD 加口香糖组被鼓励在术前禁食期间自由咀嚼口香糖，同时以相同的方式摄入口服碳水化合物。主要终点是使用阿姆斯特丹术前焦虑和信息量表（APAIS）评估术前焦虑。还将次要结局比较患者报告的术后恢复质量和全身麻醉前胃容量。
结果
与 CHD 组相比，CHD 加口香糖组的术前 APAIS 较低（16 [11.5，20] vs. 20 [16.5，23]，p = 0.008）。CHD 加口香糖组患者术后恢复质量评分也较高，且与术前 APAIS 评分呈显著负相关（相关系数：-0.950，p = 0.001）。两组胃容量无差异（0 [0-0.45] vs. 0 [0-0.22]，p = 0.158）。
结论
与单独口服碳水化合物相比，在术前禁食期间在口服碳水化合物负荷中添加咀嚼口香糖更能有效缓解妇科择期手术患者的术前焦虑。
试验注册
临床研究信息服务，CRIS 标识符：KCT0005714，https://cris.nih.go.kr/cris/index.jsp。
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