PURPOSE: The purpose of this study was to examine the effects of frozen gauze with normal saline on thirst and the oral health of patients with nasal surgery. METHODS: A quasi-experimental, nonequivalent control group pretest-post test design was used. Participants (n=52) received either gauze frozen with normal saline (n=26), or wet gauze (n=26). The subjective thirst level and oral health of the participants were assessed before the intervention, 30 minutes after the first intervention, 30 minutes after the second intervention, and 30 minutes after the third intervention. RESULTS: After oral hygiene was provided twice, the thirst level was improved in patients receiving the gauze frozen with normal saline. After oral hygiene was provided a third time, the thirst level was improved in patients receiving the gauze frozen with normal saline. CONCLUSION: Gauze frozen with normal saline can be effective for oral hygiene in reducing the thirst level and improving the oral health in nasal surgery patients.
Humans ; Nasal Surgical Procedures* ; Oral Health* ; Oral Hygiene ; Thirst*

Adipsic hypernatremia is a rare disorder of hypothalamic osmoreceptor dysfunction for thirst. It is frequently associated with a deficiency in antidiuretic hormone (ADH) release. We report the first case in Korea of adipsic hypernatremia combined with subnormal ADH response to osmotic stimuli without any demonstrable structural lesion. A 69-year-old woman was admitted to the hospital with general weakness. In a hypernatremic hyperosmolar state, she denied thirst and did not drink spontaneously. Her plasma ADH level was markedly subnormal but she had no large volume of dilute urine. Investigation of osmoregulation by infusion of hypertonic saline revealed adipsia and an absolute deficiency in antidiuretic hormone release, despite a serum osmolarity in excess of 321 mOsmol/kg. There was no structural lesion of the hypothalamus and no abnormal finding in hypothalamic-pituitary function. After diagnosis, she was treated successfully with intentional water intake alone.
Aged ; Female ; Humans ; Hypernatremia ; Hypothalamus ; Korea ; Osmolar Concentration ; Plasma ; Thirst ; Water-Electrolyte Balance

PURPOSE: Thirst has been reported as an important source of distress for patients on hemodialysis. However, there is no instrument available that assesses thirst distress of Turkish patients on hemodialysis. Therefore, the aim of this study was to examine the psychometric properties of the Turkish version of the Thirst Distress Scale (TDS-T) for patients on hemodialysis. METHODS: This study was conducted methodologically. A convenience sample of 142 Turkish patients on hemodialysis participated in this study. Data were collected by using a questionnaire, the TDS-T and a visual analogue scale for thirst intensity. The analysis of data included descriptive statistics, the one-sample Kolmogorov-Smirnov test, Kruskal-Wallis test, Mann-Whitney U test, correlation coefficients and psychometric tests. RESULTS: The TDS-T demonstrated acceptable internal consistency (Cronbach's alpha coefficient = .81), good test-retest reliability (intraclass correlation coefficient = .88), and correlations with interdialytic weight gain values and thirst intensity scores (measured by visual analogue scale) indicating concurrent and convergent validity, respectively. Construct validity was supported by known-group comparisons. The results revealed a one-component structure of the instrument. CONCLUSIONS: The psychometric properties of the TDS-T were consistent with those reported in the original study. The TDS-T was found to be a valid and reliable tool for evaluating thirst distress in patients on hemodialysis.
Humans ; Methods ; Psychometrics ; Renal Dialysis* ; Reproducibility of Results* ; Thirst* ; Turkey ; Weight Gain ; Surveys and Questionnaires

Adipsic hypernatremia cause chronic hyperosmolality and hypernatremia through a combination of impaired thirst and osmotically stimulated antidiuretic hormone secretion. This syndrome can be grouped together as disorders of osmoreceptor dysfunction due to the various degrees of osmoreceptor destruction related with different types of intracranial lesions around the anterior hypothalamus, consistent with the location of primary osmoreceptor cells. Adipsic hypernatremia, associated with developmental disorder of corpus callosum, is very rare. Most cases are diagnosed at infancy and early childhood; the replacement of desmopressin is necessary. Herein, we report adipsic hypernatremia associated with anomalous corpus callosum in adult with mental retardation; they were treated with only free water without desmopressin.
Adult ; Corpus Callosum ; Deamino Arginine Vasopressin ; Humans ; Hypernatremia ; Hypothalamus, Anterior ; Intellectual Disability ; Thirst ; Water

Backgrounds: The purpose of fasting before surgery is to minimize the volume of gastric contents. A short fast after solid food increases gastric volume, but a small drink of clear fluid 2 to 3 hours preoperatively decreases gastric volume. This investigation examined the effects of a small drink of clear fruit juice 2 to 3 hours prior to anesthesia on gastric volume, gastric pH, thirst and hunger. METHODS: Two hundred eighty children whose ages were five to ten years, scheduled for elective surgery were randomly assigned to one of 7 groups. Group 1 continued to fast but in the other 6 groups the children drank 2 ml/kg, 3 ml/kg, or 4 ml/kg of clear fruit juice (orange or grape) 2 to 3 hours preoperatively. The degree of thirsty and hunger was checked. The volume of gastric contents was measured by syringe and the pH by pH meter. RESULTS: The children who drank fruit juice preoperatively had decreased gastric volume. The gastric pH was not significantly different with that of the control group. The degree of thirst and hunger was not significantly different with that of the control group. CONCLUSIONS: We conclude that a small drink of fruit juice 2 to 3 hours preoperatively is more preferable than 8 hours fasting.
Anesthesia ; Child* ; Fasting ; Fruit* ; Humans ; Hunger ; Hydrogen-Ion Concentration* ; Syringes ; Thirst

BACKGROUND: Aspiration of gastric contents is one of the most feared complications during anesthesia. But the routine preoperative order "NPO after midnight" produces thirst, hunger, irritability and other unpleasant experiences in elective inpatients. So, we evaluated the effect of preoperative clear fluid (orange juice) intake, with and without ranitidine, on gastric volume and pH. METHODS: Sixty unpremedicated adult patients, ASA class I or II, scheduled for elective operation were randomly divided into three groups. Group I (n = 20) fasted after midnight. Group II (n = 20) ingested orange juice 150 ml, 2 3 hours before anesthesia. Group III (n = 20) ingested orange juice 150 ml with ranitidine 150 mg, 2 3 hours before anesthesia. As soon as the patients were intubated and stabilized after induction, gastric contents were collected via 16 18 French Salem Sump tube. Gastric volume and pH were measured. RESULTS: Statistically significant differences were found between groups I and II on the hand and group III on the other, in both of gastric volume and pH. But there were no significant differences between groups I and II. CONCLUSIONS: These results suggest that preoperative clear fluid intake does not affect gastric volume and pH. Moreover, concomitant administration of ranitidine decreases gastric volume and increases pH.
Adult ; Anesthesia ; Citrus sinensis ; Hand ; Humans ; Hunger ; Hydrogen-Ion Concentration* ; Inpatients ; Ranitidine* ; Thirst

BACKGROUND: Aspiration of gastric contents is one of the most feared complications during anesthesia. But the routine preoperative order "NPO after midnight" produces thirst, hunger, irritability and other unpleasant experiences in elective inpatients. So, we evaluated the effect of preoperative clear fluid (orange juice) intake, with and without ranitidine, on gastric volume and pH. METHODS: Sixty unpremedicated adult patients, ASA class I or II, scheduled for elective operation were randomly divided into three groups. Group I (n = 20) fasted after midnight. Group II (n = 20) ingested orange juice 150 ml, 2 3 hours before anesthesia. Group III (n = 20) ingested orange juice 150 ml with ranitidine 150 mg, 2 3 hours before anesthesia. As soon as the patients were intubated and stabilized after induction, gastric contents were collected via 16 18 French Salem Sump tube. Gastric volume and pH were measured. RESULTS: Statistically significant differences were found between groups I and II on the hand and group III on the other, in both of gastric volume and pH. But there were no significant differences between groups I and II. CONCLUSIONS: These results suggest that preoperative clear fluid intake does not affect gastric volume and pH. Moreover, concomitant administration of ranitidine decreases gastric volume and increases pH.
Adult ; Anesthesia ; Citrus sinensis ; Hand ; Humans ; Hunger ; Hydrogen-Ion Concentration* ; Inpatients ; Ranitidine* ; Thirst

There appeared remarkably common disorder of water balance in psychiatric patients. Approximately 30% of the chronic inpatient population drinks fluids excessively, so called polydipsic, while 5% suffers episodes of water intoxication. Water intoxication is a serious problem characterized by profound hyponatremia and a diverse neurologic signs ranging from ataxia, confusion to death. The cause of polydipsia is even less clear. Although previous studies have suggested that it is related to cognitive dysfunction the possibility of an abnormality in the osmoregulation of thirst has not been investigated. But there is the hypothesis that polydipsic, hyponatremic schizophrenics exhibit increased neuroendocrine and behavioral sensitivity to dopamine in mesolimbic tracts, in proportion to the severity of their osmoregulatory disturbance. In order to provide the optimal clinical management of these common disturbances, the author will review their pathophysiology, assessment, treatment and relationship with mental illness.
Ataxia ; Dopamine ; Humans ; Hyponatremia ; Inpatients ; Neurologic Manifestations ; Osmoregulation ; Polydipsia* ; Psychotic Disorders ; Thirst ; Vasopressins* ; Water Intoxication*

PURPOSE: In surgical procedures under general anesthesia, 6 to 8 hours of a nulla per os (NPO; nothing by mouth) has been regarded as essential for prevention of respiratory complication such as aspiration. However, recent studies have reported that oral intake of water and other clear fluids up to 2 hours before induction of anesthesia does not increase respiratory problems. The purpose of this pilot study is to investigate the safety and efficacy of a newly developed carbohydrate-rich solution in elective hernia repair surgery patients. METHODS: A group of 30 adult patients scheduled for elective surgeries under general anesthesia were enrolled. The enrolled study group of patients was permitted to drink a carbohydrate-rich solution until two hours before the operation without volume limitation. Respiratory complication was investigated in the patients using the carbohydrate-rich solution until two hours before induction of general anesthesia. The feelings of thirst, hunger sense were measured pre- and post-operatively. In addition, hoarseness of voice, nausea and vomiting were investigated post-operatively. Satisfaction regarding the short time of fasting was measured. Visual analogue scale (VAS) was used for measurement of these six variables. RESULTS: No patients showed serious respiratory complication such as dyspnea, desaturation. Eight of 30 study group patients complained of mild hoarseness. Most symptoms of hoarseness were mild, with VAS score less than 3 out of 10. Two patients complained 5 out of 10. Six patients felt nausea and 1 patient had vomiting. Pre/post-operative hunger sense and thirst feeling were 1.63/1.60 and 1.90/5.76, respectively. The satisfaction score was 3.00 out of 4. CONCLUSION: Allowing the administration of an oral carbohydrate-rich solution in elective surgery patients requiring general anesthesia is safe without serious respiratory complications and effective in providing satisfaction.
Adult* ; Anesthesia ; Anesthesia, General ; Dyspnea ; Fasting ; Herniorrhaphy ; Hoarseness ; Humans ; Hunger ; Nausea ; Pilot Projects* ; Thirst ; Vomiting ; Water

It is well known that Rhododendron sclippenbashii contains the toxic material grayanotoxin. So, Koreans do not eat it, but they do eat azalea although it contains grayanotoxin. That is why there have been no reports about Rhododendron sclippenbashii intoxication after ingesting it intentionally, not accidentally. In this case, the patient was admitted to the emergency room with several toxic symptoms after intentionally consuming 50 blossoms of Rhododendron sclippenbashii to get rid of thirst. Treatment with saline infusion and atropine was successful and the outcome was favorable enough in this case to produce a complete cure without any sequelae at discharge. But toxic symptoms were seen for 24 hours, although the symptoms usually fade in 9 hours. Therefore, we should carefully treat and observe, for over 24 hours, the patient who intentionally ingests about 50 blossoms of Rhododendron sclippenbashii.
Adult ; Atropine ; Bradycardia ; Drug Combinations ; Emergencies ; Flowers ; Humans ; Intention ; Piperonyl Butoxide ; Pyrethrins ; Rhododendron ; Thirst