Therapeutics and Clinical Risk Management (Nov 2022)
Hard-Candy Consumption Does Not Have an Effect on Volume and pH of Gastric Content in Patients Undergoing Elective Gastrointestinal Endoscopic Procedures: A Randomized Controlled Trial
Abstract
Pawit Somnuke,1 Nuanprae Kitisin,1 Phornprasurt Chumklud,1 Pishsinee Kunavuttitagool,1 Penpuk Deepinta,1 Araya Wadrod,2 Warayu Prachayakul,3 Somchai Amornyotin,1 Nattaya Raykateeraroj1 1Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand; 2Department of Nursing, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand; 3Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, ThailandCorrespondence: Nattaya Raykateeraroj, Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand, Tel +66 2 419 7990, Fax +66 2 411 3256, Email [email protected]: This study aimed to determine the effect of hard candies on gastric content volume and pH in patients undergoing elective esophagogastroduodenoscopy and colonoscopy. Additionally, the study evaluated the difficulty of the procedure, complications, and satisfaction levels of the endoscopist and patient.Patients and Methods: A randomized controlled study equally recruited 108 outpatients to candy and control groups. The patients in the candy group could consume sugar-free candies within 2 hours before anesthesia, while the controls remained fasted. The endoscopic procedure began under topical pharyngeal anesthesia and intravenous sedation. A blinded endoscopist suctioned the gastric volume through an endoscope. A blinded anesthesia provider tested the gastric pH with a pH meter. The primary outcome variables were gastric volume and pH. The secondary outcome variables were complications, the difficulty of the procedure, and endoscopist and patient satisfaction.Results: The characteristics of both patient groups were comparable. The mean gastric volume of the candy group (0.43 [0.27– 0.67] mL/kg) was not significantly different from that of the control group (0.32 [0.19– 0.55] mL/kg). The gastric pH of both groups was similar: 1.40 (1.10– 1.70) for the candy group and 1.40 (1.20– 1.90) for the control group. The procedure-difficulty score of the candy group was higher than that of the control group. The satisfaction scores rated by the endoscopist and the patients in both groups were comparable. In addition, most endoscopists and patients in the candy and control groups reported being “very satisfied”. No complications were observed in either group.Conclusion: Hard candies did not affect gastric volume or pH. Elective gastrointestinal endoscopic procedures in adult patients who preoperatively consume candies could proceed to prevent delays and disruption of workflows.Keywords: gastric pH, gastric volume, gastrointestinal endoscopy, hard candy, preoperative fasting guidelines
