We’re writing in response to a recent correspondence titled “Chewing Gum: A Hazard That Warrants Delaying the Case?” by Andrew S. Greenwald, B.A. and Yuriy A. Gubenko, M.D. (March 2015 NEWSLETTER). While we agree that preoperative gum chewing has been the subject of much controversy, a subject on which ASA has remained silent,1 we feel a more careful analysis of the literature invites an entirely different conclusion than that reached by our esteemed colleagues. More importantly, we feel particularly obliged to make the case for improved clinical practice in the area of preoperative fasting guidelines that will enhance the patient experience, given that much of what we practice in this space is nothing short of mythology that, frankly, makes our patients miserable.
The decision on whether to allow perioperative gum chewing revolves around the concern for pulmonary aspiration. At the core of the argument are four fundamental issues:...
