title: Usage of Chewing Gum in Posterior Spinal Fusion Surgery for Adolescent Idiopathic Scoliosis: A Randomized Controlled Trial.
abstract: METHODS
  Randomized controlled trial.
  
  
  OBJECTIVE
  The present study investigated the effectiveness of chewing gum on promoting faster bowel function and its ability to hasten recovery for patients with adolescent idiopathic scoliosis (AIS) after posterior spinal fusion (PSF) surgery.
  
  
  BACKGROUND
  Sham feeding with chewing gum had been reported to reduce the incidence of postoperative ileus by accelerating recovery of bowel function.
  
  
  METHODS
  We prospectively recruited and randomized 60 patients with AIS scheduled for PSF surgery into treatment (chewing gum) and control group. The patient-controlled anesthesia usage, wound pain score, abdominal pain score, nausea score, and abdominal girth were assessed and recorded at 12, 24, 36, 48, and 60 hours postoperatively. The timing for the first fluid intake, first oral intake, sitting up, walking, first flatus after surgery, first bowel opening after surgery, and duration of hospital stay were also assessed and recorded.
  
  
  RESULTS
  We found that there were no significant differences (P > 0.05) in patient-controlled anesthesia usage, wound pain score, abdominal pain score, nausea score, and abdominal girth between treatment (chewing gum) and control groups. We also found that there were no significant difference (P > 0.05) in postoperative recovery parameters, which were the first fluid intake, first oral intake, sitting up after surgery, walking after surgery, first flatus after surgery, first bowel opening after surgery, and duration of hospital stay between both groups. The wound pain was the worst at 12 hours postoperatively, which progressively improved in both groups. The abdominal pain progressively worsened to the highest score at 48 hours in the treatment group and 36 hours in the control group before improving after that. The pattern of severity and recovery of wound pain and abdominal pain was different.
  
  
  CONCLUSIONS
  We found that chewing gum did not significantly reduce the abdominal pain, promote faster bowel function, or hasten patient recovery.
  
  
  METHODS
  1.
authors.affiliation: Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Chris Yin Wei
authors.initials: CYW
authors.lastname: Chan
authors.affiliation: Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Chee Kidd
authors.initials: CK
authors.lastname: Chiu
authors.affiliation: Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Chee Kean
authors.initials: CK
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Siti Mariam Abd
authors.initials: SMA
authors.lastname: Gani
authors.affiliation: Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Siti Mariam
authors.initials: SM
authors.lastname: Mohamad
authors.affiliation: Department of Anaesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Mohd Shahnaz
authors.initials: MS
authors.lastname: Hasan
authors.affiliation: Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Mun Keong
authors.initials: MK
authors.lastname: Kwan
mesh_terms: D000293:Adolescent; D002638:Chewing Gum; D002648:Child; D003672:Defecation / Q000502:physiology; D005260:Female; D006801:Humans; D045823:Ileus / Q000209:etiology* / Q000517:prevention & control; D007902:Length of Stay / Q000639:trends; D008297:Male; D010865:Pilot Projects; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D011446:Prospective Studies; D012600:Scoliosis / Q000453:epidemiology / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects* / Q000639:trends; D055815:Young Adult
chemical_list: D002638:Chewing Gum