Search

There is a lack of consensus regarding the preoperative fasting period on gum chewing due to conflicting evidence. Our study aimed to determine the effects of preoperative sugarless gum chewing on gastric fluid volume and pH. This prospective randomised study was performed on patients who underwent elective operation under general anaesthesia. Sixty patients who fasted overnight were randomly assigned to either "non-chewing gum" as control or "chewing gum group" as intervention group who chewed one piece of gum upon the call to the operating theatre. They were further enquired whether gum chewing helped cope with hunger and reduced anxiety. Gastric volume and pH were determined immediately after induction of anaesthesia. Gum chewing had no significant effect on gastric fluid volume measured [30.4+13.6 (control) vs 29.1+11.6 ml (intervention), p = 0.693] and gastric fluid pH [1.4+0.4 (control) vs 1.6+0.4 (intervention), p = 0.05] while managing to reduce anxiety in 90.3% patients who chewed gum. Pre-operative gum-chewing did not increase in gastric fluid volume or a further reduction in gastric fluid acidity and was able to reduce anxiety in patients in the preoperative period. [ABSTRACT FROM AUTHOR]

Sepsis and atherosclerotic cardiovascular disease (ASCVD) are major health challenges involving complex processes like inflammation, renin-angiotensin system (RAS) dysregulation, and thrombosis. Despite distinct clinical symptoms, both conditions share mechanisms mediated by bradykinin. This review explores bradykinin's role in inflammation, RAS modulation, and thrombosis in sepsis and ASCVD. In sepsis, variable kininogen-bradykinin levels may correlate with disease severity and progression, though the effect of bradykinin receptor modulation on inflammation remains uncertain. RAS activation is present in both diseases, with sepsis showing variable or low levels of Ang II, ACE, and ACE2, while ASCVD consistently exhibits elevated levels. Bradykinin may act as a mediator for ACE2 and AT2 receptor effects in RAS regulation. It may influence clotting and fibrinolysis in sepsis-associated coagulopathy, but evidence for an antithrombotic effect in ASCVD is insufficient. Understanding bradykinin's role in these shared pathologies could guide therapeutic and monitoring strategies and inform future research., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)