Expert: Ronald Levy, M.D. - 9/12/2008

Question
Dr. Levy,

Do you know what the ASA NPO guidelines are for chewing gum?  I find some resources that say gum chewing does not lower gastric pH and increase gastric volume, but some sources say the opposite.  Would you cancel or postpone a case for a patient that has chewed gum?  This is for IV sedation (with versed, fentanyl, and propofol).  Also, do you require patients to fast 6 or 8 hours for solid foods?  Thanks for your help!

Answer
I take a literal approach and would postpose the case. I am not sure if gum was addressed in the ASA guidelines but the current guidelines say 6 hours with no other aspiration risks or 8 hours with other aspiration risks.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston