Key result
Chewing gum significantly reduced the incidence of postoperative nausea and vomiting at 6 hours compared to intravenous ondansetron (3.33% vs 31.67%, p<0.0001) in women undergoing elective caesarean delivery.
Why the study?
The study was conducted to compare ondansetron versus chewing gum for the prevention of postoperative nausea and vomiting in patients undergoing elective LSCS.
Does chewing gum improve relief of post-operative nausea and vomiting compared to ondansetron in patients undergoing elective caesarean delivery?
RCT (n=120)
Open-label
Randomized
No
Does chewing gum improve relief of post-operative nausea and vomiting compared to ondansetron in patients undergoing elective caesarean delivery?
Chewing gum is a safe, well-accepted, and effective alternative to intravenous ondansetron for preventing post-operative nausea and vomiting and accelerating return of bowel function after elective cesarean delivery.
Answers are grounded in this paper and cite their sources.
Supports chewing gum over ondansetron for post-cesarean PONV prevention; extends non-pharmacologic options in obstetric postoperative care.
Aim: to compare the ondansetron versus chewing gum for prevention of post-operative nausea and vomiting in patients undergoing elective LSCS. Material and methods: This was prospective Randomized trial done in the Department of Anesthesia.. A total of 120 patients for elective caesarean delivery were included in the study. Patients in Group I were given one strip of sugar free gum to be chewed for 30 minutes every eighth hourly. Patients randomized to Group-II received Inj. Ondansetron 4mg intravenously immediately after cesarean section. The relief of PONV as graded on a four-point verbal descriptive scale, and Five point Likert scale for acceptability, 3) Use of rescue medication for the first 24 hours after surgery 4) Sedation, as assessed with RAMSAY sedation scale and 5) Time to first flatus. Results: 2 patient in chewing gum group and 19 patients in Ondansetron group had episodes of nausea at 6th hour postoperatively, whereas 2 patient in chewing gum group and 10 patients in Ondansetron group had PONV at 12th hour. However, rescue medication was not required for these patients. It was observed that there was statistically significant difference between the two groups at 6th and 12th hour where the maximum number of events of PONV had occurred. On the scale for relief of PONV, it was observed that there was full resolution of PONV in more number of patients in chewing gum group than in the Ondansetron group. In the Likert scale response, the patients were more comfortable in the chewing gum group than in Ondansetron Group. Our data shows a beneficial effect of gum chewing in terms of better relief of post-operative nausea and shorter mean time intervals to passage of flatus (21.42 versus 30.49 hours) and acceptability. Conclusion: chewing gum is considered safe, well accepted better alternative to Ondansetron for the treatment of PONV in this randomized controlled study undergoing cesarean delivery under spinal anaesthesia. It also results in rapid resumption of intestinal motility, with potential impact on reducing the overall healthcare costs in case of routine implementation.
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Sunil Kumar (2020) conducted an RCT in Postoperative nausea and vomiting (PONV) (n=120). Chewing gum vs. Intravenous Ondansetron 4mg was evaluated on Incidence of postoperative nausea and vomiting (PONV) at 6 hours (p=< 0.0001). Chewing gum significantly reduced the incidence of postoperative nausea and vomiting at 6 hours compared to intravenous ondansetron (3.33% vs 31.67%, p<0.0001) in women undergoing elective caesarean delivery.
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