Letter to the Editor  |   March 2015
Add Chewing Gum to 6-Hour Fasting Guidelines
Author Affiliations
  • Michael T. Kissel, M.D.
    Atlanta, Georgia
Article Information
Letter to the Editor
Letter to the Editor   |   March 2015
Add Chewing Gum to 6-Hour Fasting Guidelines
ASA Monitor 03 2015, Vol.79, 51.
ASA Monitor 03 2015, Vol.79, 51.
The letter written by Mr. Greenwald and Dr. Gubenko regarding chewing gum published in the November 2014 ASA NEWSLETTER brought to mind a recent case where chewing gum was involved. An obese female teenager presented to an ambulatory surgery center for tonsillectomy. She reported that she was NPO since dinner the night before. After I.V. induction and intubation, the surgery proceeded routinely. Prior to extubation, an oral airway was placed, and a suction catheter was passed through the oral airway to remove any remaining blood or secretions. When the catheter was removed, strings of recently chewed mint gum were attached. A second catheter was placed and the remaining gum was removed. Upon removal of the oral airway, the gum had adhered to the inside of it as well. The patient was ultimately extubated without any further issue and recovered without complication. When the patient was awake enough to talk, she admitted she had chewed and swallowed the gum just prior to her surgery. The patient and her mother were educated on the importance of avoiding chewing gum prior to surgery in the future to avoid potential airway complications. Attached are photographs of the suction catheters and oral airway. I would agree that chewing gum should be added to the six-hour fasting guidelines based on this experience.
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