N Brundha, Biradar Aruna, Patil Neelamma, Yaliwal Rajasri G, Biradar Priyanka, Gupta Namita, Kulkarni Sharanabasava S
Obstetrics and Gynaecology, Shri B. M. Patil Medical College and Research Centre, Vijayapura, IND.
Cureus. 2024 Aug 30;16(8):e68210. doi: 10.7759/cureus.68210. eCollection 2024 Aug.
Background and objective Cesarean sections (CS) are common and occasionally critical surgical procedures. Nausea, vomiting, and postoperative ileus (POI) frequently occur in patients undergoing cesarean delivery with regional anesthesia. These issues affect patient comfort, slow down wound healing, and prolong hospital stays. Studies have employed various strategies to address these challenges. Chewing gum post-surgery is a cost-effective approach to stimulate intestinal movement, promoting early initiation of oral intake, early mobilization, shorter hospital stays, and reduced overall hospitalization time. In this study, we aimed to investigate the potential benefits of chewing gum in this patient population. Methodology We randomly assigned a total of 314 women scheduled for elective or emergency lower segment CS (LSCS) to either a gum-chewing group (Group A, n=157) or a control group receiving standard postoperative care (Group B, n=157). Participants in the gum-chewing group chewed sugar-free gum for one hour postoperatively in sessions lasting 15 minutes each, continuing until bowel sounds resumed, and were allowed to have oral sips of water. In contrast, the control group's bowel sounds were checked every half hour till they appeared, and women were allowed to have sips of water once the bowel sounds were heard. The primary comparisons between the groups focused on the timing of first bowel sounds, first passage of flatus, and first bowel movement. Secondary endpoints included time to mobilization, removal of the catheter, and subjective sense of well-being. Results The average age of women in both groups was 24 years. There were no statistically significant differences between the study and control groups concerning age, parity, occupation, type of CS, reasons for CS, skin incision, or intraperitoneal adhesions. In Group A, the mean time for bowel sounds to appear was 3.39 hours, compared to 6.91 hours in Group B. For flatus passage, the mean time was 12.74 hours in Group A and 20.51 hours in Group B. Stool passage took an average of 41.59 hours in Group A and 64.03 hours in Group B. Conclusions Chewing gum, a type of simulated eating, is linked to faster restoration of gastrointestinal function following CS. This study elucidates the mechanisms behind the benefits of chewing gum and explores its potential in diverse surgical populations. Ultimately, integrating chewing gum into postoperative care may offer a valuable tool for enhancing patient outcomes and accelerating recovery, provided it is used in conjunction with comprehensive and personalized postoperative care strategies. It is a cost-effective approach that accelerates the recovery of intestinal movement post-surgery, decreasing the length of hospital stay and overall burden on patients.
背景与目的 剖宫产是常见且偶尔具有关键性的外科手术。在接受区域麻醉的剖宫产患者中，恶心、呕吐和术后肠梗阻（POI）经常发生。这些问题影响患者舒适度，延缓伤口愈合，并延长住院时间。研究采用了各种策略来应对这些挑战。术后嚼口香糖是一种经济有效的促进肠道蠕动的方法，可促进早期开始经口进食、早期活动、缩短住院时间并减少总体住院时长。在本研究中，我们旨在调查嚼口香糖对该患者群体的潜在益处。
方法 我们将总共314名计划进行择期或急诊下段剖宫产（LSCS）的女性随机分为嚼口香糖组（A组，n = 157）或接受标准术后护理的对照组（B组，n = 157）。嚼口香糖组的参与者术后每15分钟嚼无糖口香糖1小时，持续至肠鸣音恢复，并允许小口饮水。相比之下，对照组每半小时检查一次肠鸣音，直至肠鸣音出现，听到肠鸣音后女性才被允许小口饮水。两组之间的主要比较集中在首次肠鸣音出现的时间、首次排气时间和首次排便时间。次要终点包括活动时间、拔除导尿管时间和主观幸福感。
结果 两组女性的平均年龄均为24岁。在年龄、产次、职业、剖宫产类型、剖宫产原因、皮肤切口或腹腔粘连方面，研究组和对照组之间无统计学显著差异。A组肠鸣音出现的平均时间为3.39小时，B组为6.91小时。排气方面，A组平均时间为12.74小时，B组为20.51小时。排便方面，A组平均用时41.59小时，B组为64.03小时。
结论 嚼口香糖作为一种模拟进食方式，与剖宫产术后胃肠功能更快恢复有关。本研究阐明了嚼口香糖益处背后的机制，并探讨了其在不同手术人群中的潜力。最终，将嚼口香糖纳入术后护理可能为改善患者预后和加速康复提供一种有价值的工具，前提是它与全面且个性化的术后护理策略相结合使用。这是一种经济有效的方法，可加速术后肠道蠕动恢复，减少住院时间和患者的总体负担。
