Comparison Of Different Non-Pharmacological Preoperative Preparations On Gastric Fluid Volume And Acidity: A Randomized Controlled Trial

Objectives: Aspiration of gastric contents is one of the major causes of general anesthesia related morbidity and mortality. This study aimed to compare the effects of using different non-pharmacological preparations preoperatively on gastric fluid volume and pH.Methodology: This randomized, controlled trial was conducted at a teaching hospital in Shiraz, Southern Iran. Overall, 150 patients were randomly selected from elective surgery candidates, who were 17-95 years old, fulfilled the criteria of American Society of Anesthesiologists (ASA) grade-I or II, and in which tracheal intubation was indicated. The patients were allocated randomly to one of the following five groups: Group A: continuously chewed bicarbonate-containing gum for 2 hours before anesthesia induction until premedication. Group B: continuously chewed standard sugar free gum 2 hours before anesthesia induction until premedication. Group C: sucked lollipop 2 hours before anesthesia induction. Group D: drank pure water 10 ml/kg 2 hours before anesthesia induction. Group E (control group): without any intervention.Results: The mean volume of gastric fluid was not significantly different among the study groups. In the group who chewed bicarbonate gum, the mean +/- SE gastric fluid pH was significantly higher than in other groups [5 +/- 1 vs. 3 +/- 1 respectively, P<0.001].Conclusion: Increased gastric fluid pH following the use of bicarbonate gum for pre-operative preparation may have implications for preventing aspiration and enhancing anesthesia care.