Dubin S A, Jense H G, McCranie J M, Zubar V
Department of Anesthesiology, Medical College of Georgia, Augusta 30912.
Can J Anaesth. 1994 Jul;41(7):603-6. doi: 10.1007/BF03010000.
Patients occasionally arrive in the operating suite chewing gum despite instructions to avoid oral intake for a specific number of hours before surgery. Some anaesthetists are hesitant to proceed with these patients fearing an increase in gastric volume and acidity. This study was undertaken to determine if gum chewing increased gastric volume and acidity. Seventy seven patients were recruited and informed consent obtained. Thirty-one patients who fasted overnight were randomly assigned either to serve as control (Group 1) or to chew sugarless gum prior to anaesthesia (Group 2). The remaining 46 patients fasted overnight but were given sugarless gum and allowed to chew it until immediately before induction of anaesthesia if they desired (Group 3). Volume and pH of gastric content were determined immediately after induction of anaesthesia and tracheal intubation. Results revealed mean values (range) of gastric volume for Group 1-26 ml (9-60), Group 2-40 ml (5-93), and Group 3-28 ml (4-65). Mean values for pH (range) were Group 1-1.8 (1.0-4.6), Group 2-1.6 (1.3-1.9), Group 3-1.7 (1.0-4.4). There was no difference between groups in terms of gastric volume or pH. In addition, there was no relationship between gastric content and the length of time from gum discard to induction or the length of time gum was chewed. In conclusion, the data suggest that induction of anaesthesia is safe and surgery does not need to be delayed if a patient arrives in the OR chewing sugarless gum.
尽管已告知患者在手术前特定时长内避免经口摄入,但仍有患者偶尔会在进入手术室时嚼口香糖。一些麻醉医生对于为这些患者实施麻醉犹豫不决,担心胃内容物量和酸度会增加。本研究旨在确定嚼口香糖是否会增加胃内容物量和酸度。招募了77名患者并获得了知情同意。31名过夜禁食的患者被随机分配,要么作为对照组(第1组),要么在麻醉前嚼无糖口香糖(第2组)。其余46名患者过夜禁食,但给予无糖口香糖,并允许他们在有意愿的情况下一直嚼到即将进行麻醉诱导前(第3组)。在麻醉诱导和气管插管后立即测定胃内容物的量和pH值。结果显示,第1组胃内容物量的平均值(范围)为26毫升(9 - 60),第2组为40毫升(5 - 93),第3组为28毫升(4 - 65)。pH值(范围)的平均值为,第1组1.8(1.0 - 4.6),第2组1.6(1.3 - 1.9),第3组1.7(1.0 - 4.4)。各组之间在胃内容物量或pH值方面没有差异。此外,胃内容物与从丢弃口香糖到诱导麻醉的时长或嚼口香糖的时长之间没有关联。总之,数据表明,如果患者在进入手术室时嚼无糖口香糖,麻醉诱导是安全的,手术无需延迟。