The Effects of Chewing Gum on Postoperative Nausea and Vomiting.

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Postoperative nausea and vomiting (PONV) is a common complication that may cause significant morbidity. It is usually treated with anti-emetics. Recently, Chewing Gum (GC) showed similar level of efficacy to ondansetron in a pilot controlled trial of surgical patients. Moreover, CG has bee shown to reduce postoperative gut malfunction and vomiting after colorectal surgery However, to date, CG has not bee studied in the prevention of PONV in patients admitted to the intensive care unit (ICU). Thus we aim to perform a study to evaluate the comparative effect of CG compared with the effects of taking a 20 ml sip of water in the prevention of PONV in patients admitted to the ICU after major surgery. Patients will be randomly allocated to be given sugarless plain CG or a 20 ml sip of water 4 hourly for 24 hours. The nurse looking after the patient will record the effects of the intervention on the presence of nausea, its duration, and severity using a visual analogue scale every 4 hours. The number of episodes of vomiting and retching will be recorded. Rescue anti-emetic therapy if the nausea is rated > 5, or if vomiting has occurred. Nausea and vomiting assessments will be made 30 minutes after the patient had been given rescue medication. If the CG intervention proves effective, it will represent an important and easily deployed, safe step towards making the patient's post-operative period less distressing.