Chewing Gum- Sweet Solution for Postoperative Nausea and Vomiting, suggests study

Recent study aimed to assess the effectiveness of chewing gum as a rescue antiemetic compared to intravenous ondansetron in female patients experiencing postoperative nausea and vomiting in the post-anesthesia care unit. The multicenter randomized controlled trial included female patients aged 12 years or older undergoing laparoscopic or breast surgery under general anesthesia. Patients who developed postoperative nausea and vomiting were randomized to receive either 15 minutes of chewing gum or 4 mg intravenous ondansetron.

Comparison of Chewing Gum vs. Ondansetron

Results showed that chewing gum was not noninferior to ondansetron, with a lower percentage of patients achieving the primary outcome of complete response with chewing gum compared to ondansetron. Patients receiving chewing gum had a longer time to complete response and were more likely to require rescue antiemetics in the 24 hours post-surgery. The study demonstrated that chewing gum was not as effective as ondansetron in treating postoperative nausea and vomiting, despite both groups receiving antiemetic prophylaxis.

Conclusion on Chewing Gum vs. Ondansetron

The study highlighted the importance of effective postoperative nausea and vomiting management, especially in high-risk patients undergoing surgeries. Even with prophylactic antiemetics, nausea and vomiting remain significant concerns post-surgery. While chewing gum may offer advantages like ease of administration and lack of adverse effects, it did not prove to be as effective as ondansetron in this trial.

Implications and Recommendations

The researchers emphasized the need for alternative rescue treatments for postoperative nausea and vomiting, as current guidelines recommend prophylactic antiemetics. The trial results indicated that chewing gum could not be recommended as a substitute for ondansetron in treating postoperative nausea and vomiting in female patients. Further research may be necessary to explore the effectiveness of chewing gum in different patient populations or surgical scenarios.

Key Points

- The study compared the effectiveness of chewing gum versus intravenous ondansetron as rescue antiemetics in female patients experiencing postoperative nausea and vomiting after laparoscopic or breast surgery under general anesthesia.

- Chewing gum was found to be not noninferior to ondansetron, as a lower percentage of patients achieved a complete response with chewing gum compared to ondansetron. Additionally, patients who received chewing gum took longer to achieve a complete response and were more likely to require rescue antiemetics within 24 hours post-surgery.

- Despite both groups receiving antiemetic prophylaxis, chewing gum was demonstrated to be less effective than ondansetron in the treatment of postoperative nausea and vomiting.

- The study underscored the significance of effective management of postoperative nausea and vomiting, particularly in high-risk surgical patients. Nausea and vomiting continue to be notable concerns after surgery, even with prophylactic antiemetics.

- Although chewing gum offers advantages such as easy administration and lack of adverse effects, it did not prove to be as effective as ondansetron in this trial, suggesting the need for alternative rescue treatments based on the study findings.

- The researchers recommended further exploration of alternative rescue treatments for postoperative nausea and vomiting since chewing gum could not be endorsed as a substitute for ondansetron in the context of treating postoperative nausea and vomiting in female patients. Additional research might be necessary to evaluate the efficacy of chewing gum in diverse patient groups or surgical settings.

Reference –

J. Darvall et al. (2024). Chewing Gum To Treat Postoperative Nausea And Vomiting In Female Patients: A Multicenter Randomized Trial.. *Anesthesiology*. https://doi.org/10.1097/ALN.0000000000005283.