Three ways to quench thirst after surgery

In the surgical ward, you can often see this scene: the patient has just returned to the ward from the operating room, and the family members anxiously ask the nurse: "Nurse, can our patient drink water now?"

Nurse: "You can't drink water yet."

Family member: "What if he/she is thirsty? Can I use a wet cotton swab to wipe his/her mouth?"

Nurse: "We do not recommend using a cotton swab to wet the mouth, because simply moistening the lips is not enough to relieve the patient's thirst symptoms, and as the water evaporates, it will accelerate the drying of the lips[1], making the patient even thirstier."

Before solving the problem of thirst after surgery, we need to understand what thirst is. The International Classification for Nursing Practice (ICNP) proposed the term "thirst" and defined it as "the feeling of dryness of the oral and throat mucosa and the desire to drink water or other liquids" [2]. Thirst is a subjective feeling of the patient [3]. Feelings are the reflection of objective things in the internal and external environment in the human brain. Changes in the internal and external environment first stimulate the body's receptors or sensory organs, and then convert them into corresponding nerve impulses, which reach the relevant parts of the cerebral cortex along certain nerve conduction pathways. After being analyzed and processed by the brain, the corresponding sensation can be generated. Due to long-term fasting and water, the surface receptors such as the lips and periorbital area lack water stimulation, which produces a sense of thirst [4].

So what are the safe and convenient methods that can improve patients’ thirst caused by temporary water deprivation after surgery?

Method 1: Apply cucumber slices to the lips and area around the mouth[4]

Cut cucumber into 3-4 slices and apply them to the patient's lips and mouth area[5]. Cucumbers have a water content of up to 98%, and they emit a sweet fragrance after being sliced. Li Shizhen mentioned in his famous medical work "Compendium of Materia Medica" that "cucumbers are sweet and cold in nature, and have multiple functions such as clearing heat and cooling blood, detoxifying and anti-inflammatory, quenching thirst, promoting diuresis, removing dampness, and moistening the intestines." Therefore, applying cucumber slices to the lips and the surrounding area can not only moisturize the lips, but also absorb its nutrients through the skin, helping to maintain the moisture of the mouth.

Cucumber slices can provide long-lasting stimulation and are not easy to fall off, producing the superposition effect of moisture stimulation of "multiple stimulations acting continuously in the same area" and "multiple stimulations acting simultaneously in adjacent areas". This effect can continuously stimulate the generation of surface receptor potentials and frequently transmit nerve impulses for adequate water. These impulses are transmitted to the brain center through the pathway of nerve transmission, continuously producing a sense of adequate water, thereby significantly reducing the patient's thirst. Therefore, during the patient's fasting period, the cucumber slices on the lips and around the mouth continue to emit a sweet and refreshing fragrance, stimulating the patient to secrete a large amount of saliva, moistening the dry mouth, and significantly reducing the patient's thirst.

Method 2: Room temperature water spray[6]

One way to relieve thirst is to use room-temperature drinking water. After the patient returns to the room, instruct the family to clean a 60ml sprayer, fill it with room-temperature drinking water, and mark the sprayer on the outside. When the patient is in the postoperative fasting stage and feels dry mouth and thirst, instruct the family to gently press the sprayer and aim the sprayer at the patient's mouth and inside the mouth to spray once, which can be repeated every 2 hours.

Method 3: Mint popsicles[7]

Mint-flavored popsicles use the dual stimulation of cold and menthol to activate osmotic pressure receptors and cold TRPM8 receptors in the oropharynx, thereby rapidly reducing the level of antidiuretic hormone and bringing a cool and pleasant feeling to the oropharynx. This flavor of popsicle can not only effectively relieve the thirst symptoms of postoperative patients, but also achieve this effect more efficiently.

The combination of low temperature and menthol can activate the trigeminal nerve and glossopharyngeal nerve receptors in the oropharynx, rapidly reducing the level of antidiuretic hormone in the body. This physiological response brings patients a refreshing and pleasant oropharyngeal experience. In addition, taking popsicles or borneol does not increase the risk of aspiration. Therefore, mint-flavored popsicles, as an effective intervention measure, have shown good results in clinical practice, especially in relieving thirst.

The above are cheap and effective measures to relieve patients’ thirst after surgery. Do you understand?

[1] Zhao Bin, Jiang Liping. Expert consensus on the assessment and management of thirst symptoms in adults after surgery[J]. Military Nursing, 2022, 39(12): 1–4.

[2]Alves do Nascimento L, de Oliveira Lopes MV, Fahl Fonseca L. Development and validation of a new nursing diagnosis: Perioperative thirst[J]. International Journal of Nursing Knowledge, Wiley Online Library, 2021, 32(4): 253–261.

[3] Lin Rong, Hong Li. Research progress on thirst in critically ill patients[J]. Chinese Journal of Nursing, 2016.

[4] Gao Lanfeng, Zhang Jianping, Lu Lingxiang, et al. Effects of different nursing interventions on postoperative thirst in surgical patients[J]. Contemporary Medical Forum, 2015, 13(18): 93–94.

[5] Si Baohong. Nursing measures for patients with thirst after orthopedic general anesthesia [J]. Chinese and Foreign Women's Health Research, 2019(23): 165–166.

[6] Zhang Qi, You Wenxuan. Evaluation of the effect of non-drug local intervention on improving thirst intensity in postoperative intensive care patients[J]. Journal of Fudan University (Medical Edition), 2021, 48(1): 66–70.

[7] Liu X, Xie JQ, Zhang T, et al. Network Meta-analysis of the effect of non-drug intervention on relieving thirst intensity in postoperative patients[J]. Journal of Nursing Continuing Education, 2022, 37(19): 1779–1785.

Liao Yu, First Affiliated Hospital of Chengdu Medical College

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