The article I chose to review for this assignment was titled, “Advances in the Management of Peri-operative Patients’ Thirst.” As a peri-operative nurse, I’m often involved in different areas of the peri-operative experience. While working in pre-op as well as PACU, one of the biggest complaints from the patients is that they are extremely thirsty. This journal article investigates the correlation between thirst and discomfort in the post-op patient. They researches found that when extreme thirst is present, the patient discomfort increases and their post-operative experience is worsened. The authors continue to discuss strategies for the PACU nurse to aid in eliminating the post-op thirst safely to enhance the patients post-op experience. fishbone template charity Morris
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There is no denying that patient’s can easily correlate discomfort and dissatisfaction post-op when they are thirsty and unable to drink. While the swabs are helpful to alleviate some discomfort they can often feel like more of a tease. Allowing a patient to drink after surgery can be tricky as they can aspirate from still being groggy from anesthesia, however some physicians are allowing patients to have small amounts of ice chips post op. This can make a big difference in patient satisfaction.
Whitlock, J., & Msn. (2019, December 13). All About General Anesthesia. Retrieved from https://www.verywellhealth.com/before-during-and-after-general-anesthesia-4150168
As a Peri-operative nurse, I witness this often. In pre op patients are less concerned with the lack of food, and more concerned about the fact that they have not had anything to drink. In recovery, when they wake they immediately request a sip of water or ice chips. At our facility it is part of or policy to have a cup of ice chips and water waiting at the bed side table for patients. Our surgeries are all out patient surgeries, so the recovery process is much different than for inpatient surgeries. I can attest to the fact that they do recover quicker after quenching their thirst. ‘Many studies have shown the benefit and safety of oral fluid after general anesthesia [5-10]. The advantages include rapid return to normal diet, early ambulation, early bowl movement, reduced thirsty and increased satisfaction (Yin, 2014).’
Yin,Xiaorong,& Ye,Ling,& Zhao,Liang,& Li,Lisha, & Song, Jinping (15 October 2014)Early versus delayed postoperative oral hydration after general anesthesia: a prospective randomized trial. International Journal of Clinical and Experimental Medicine. 7(10): 3491–3496. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4238515/
Hi there. I can relate to this problem as I am also a peri-operative nurse. I found it interesting about the study in which the patient was allowed to chew menthol gum for 10 minutes. We often have patients come in preoperatively chewing gum. Our anesthesia group does still frown on that as they say it stimulates the gastric juices. I read in your article that a meta-analysis study was done and they concluded that chewing gum did not stimulate gastric juices enough to increase the risk of bronchoaspiration. I know our anesthesia group knows about these studies but they are probably scared to allow chewing gum because they are so concerned about the patient’s well being. I do wish they would change their protocol to clears up to 2 hrs pre-op. It would help the patient both pre and post so much.
I also like the recommendation to have the patient cough and swallow prior to initiating any oral intake. I will start implementing that in my practice as well.
Thanks for the article. It is an interesting read.
Our facility too is still under the belief that anything by mouth is contraindicated prior to surgery, however, we have both cancelled and continued surgeries based on chewing gum. I have found it depends on the anesthesia provider and their comfort level. I found this to be a helpful article as well as so many patients wake up extremely thirsty, and wish for fluids, but cannot keep their eyes open or can barely speak. After reading this article I shared the findings with my coworkers. They found it insightful and helpful as well.
I am stepping out of my comfort zone in responding to your post. I cannot claim to know much about perioperative nursing. Do you find that thirst is the most common complaint expressed by patients, or do you find that there is commonly complaints about hunger? I imagine that for those that are coffee drinkers or for those who are nicotine addicts, that might be a significant complaint. Being thirsty causes distress in most individuals, and I can only imagine that properly addressing that symptom would lead not only to better patient satisfaction but to improved outcomes as the distress an individual experiences prior to surgery is potentially amplified by the additional discomfort of thirst. In a study from 2018, researchers found that the use of an ice popsicle was more effective at treating post-operative thirst than room temperature water (Conchon, M & Fonseca, L., 2018). The study did discuss the use of moistened swabs and small quantities of ice chips in the introduction but stated that the other studies which were performed regarding the use of these interventions were not conducted via experimental design. I would be curious to see if providing frozen swabs provided similar reduction in discomfort without causing concern to the anethesiologists.
Conchon, M., & Fonseca, L. (2018). Efficacy of an Ice Popsicle on Thirst Management in the Immediate Postoperative Period: A Randomized Clinical Trial. Journal of PeriAnesthesia Nursing, 33(2), 153-161.
Thirst is by far the most common first complaint of patients, and once they are allowed a sip of water they act as though they had just spent a day in the desert deprived of water or any fluids. Coffee drinkers, or those who usually drink caffeine may acquire a headache along with hunger, thirst and pain. As a post operative nurse, I try to avoid headaches and ask the patient if they usually drink caffeine and offer it along with water. We generally start with ice chips and move to water with most patients, but we are an ancillary surgery center, so all patients are intended to go directly home without an extended hospital stay. This gives the nursing staff the flexibility to offer fluids to our patients as soon as they wake.
This is not my specialty but as a nurse, you want to make your patient as comfortable as possible. Being thirsty creates a lot of distress to a normal person. What if the person is coming out of surgery, undergoing tremendous pain and discomfort. Therefore, thirst should be assessed to comfort the person from further irritation. I completely agree that proper measures should be taken to manage thirst to post-operative patients.
In addition to providing patient comfort and satisfaction, we also try to expedite the pain relief process, and giving fluids allows us to give the patient their prescribed pain medicine they will go home with. We can then assess how they will react to the pain medication, and helps us determine if the right medication was prescribed. From my professional experience, patients wake up and immediately complain of extreme thirst. I can say from personal experience, it is far easier for patients to recover quicker and better when their thirst is quenched.