Nausea and
vomiting are common complications in patients undergoing caesarean delivery under regional anaesthesia. When experienced after surgery, they may delay recovery, reduce patient satisfaction and affect the bonding between mother and baby. Various pharmacological and non-pharmacological approaches for prophylaxis and treatment of
postoperative nausea and vomiting (
PONV) have been employed with different degree of efficacy. In this pilot randomised controlled trial, we aimed to determine the possible preventative effects of
chewing gum on the rate of
PONV in expectant mothers undergoing neuraxial anaesthesia for elective lower segment
caesarean section. All participants underwent spinal anaesthesia with administration of 10-11.5 mg of intrathecal heavy Bupivicaine 0.5% according to anaesthetists' preference,
Morphine 100 μg and
Fentanyl 25 μg. Postoperative
analgesia regimen was also standardised. Two hundred ninety-six patients were randomised to an intervention arm to receive
chewing gum in addition to standard
therapy and to a non-intervention arm to receive standard
therapy. After exclusions, 258 patients were followed up 24 h postoperatively. Standard
therapy is defined as
Ondansetron 4 mg IV intra-operatively. The primary outcomes were the incidences of
nausea and
vomiting in the first 24 h postoperatively. Secondary outcomes were the number of episodes of
nausea or
vomiting in the recovery room and on the ward 24 h postoperatively, use of
anti-emetics postoperatively, severity of
nausea and patient satisfaction with the intervention. Our study revealed no significant differences in rates of
postoperative nausea and vomiting between the intervention and standard
therapy groups (41.4% v 36.9% p = 0.461). There were no significant differences in secondary outcomes between groups.
Chewing gum does not reduce the incidence of
PONV after elective LSCS under spinal anaesthesia. Our trial was registered with clinicaltrials.org (NCT04191694).