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*

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

Sodium concentration in the hemodialysis solution has been increased to prevent intradialytic hypotension after highly effective and shortened time hemodialysis(HD) was introduced in the late 70's. Many authors have pointed out that the high concentration in the dialysate sodium HD may be one of causes of increasing difficulty in the management of hypertension in HD patients. Sodium profiling hemodialysis (SPHD) is a modified form of high sodium dialysate HD. Even though sodium concentration is decreased progressively to the conventional level during the HD session, the time-averaged sodium concentration is usually higher compared to that of conventional HD. To evaluate the effect of dialysate sodium concentration on interdialytic blood pressure(BP) control, we conducted a cross over study. Eleven patients showing more than four episodes of intradialytic hypertension per month were studied(5 male, 6 female; 52+-13 years). All subjects underwent 8-week conventional HD(CHD)(dialysate Na+ 138mEq/L X 4 hour) and 8-week step-down SPHD(Na+ 150mEq/L X 2 hours> OR =140 X 1> OR =138 X 1) on the order of random assignment. At the end of each peiords, interdialytic 24-hour BP were measured by 24-hour Ambulatory BP monitor(ABPM : 90207, Space Labs, USA). 1) Time-averaged sodium concentration in dialy sate were 138mEq/L during SPHD and 144.5mEq/L during CHD. Pre HD serum sodium were not significantly different between two periods but post HD serum sodium and intradialytic increase of serum sodium significantly higher during SPHD period 138.1+/-0.5 v 141.1+/-0.6mEq/L, 0.5+/-0.6 v 2.6+/-0.4mEq/L, p<0.05). Dry weight was determined before the start of study and not changed throughout the study periods. Interdialytic weight gain and the amount of ulfrafiltration required to maintain the determined dry weight were significantly higher during SPHD period compared to those during CHD period(2.5+/-0.5 v 3.6+/-0.6 kg, 2.6+/-0.8 v 3.6+/-0.8kg, p<0.01). 2) The frequency of interdialytic hypotension was significantly reduced during SPHD period(23.9 v 15 %, p<0.01). But the frequency of symptoms requiring intervetion such as ultrafiltration adjustment or saline infusion was not different between two periods. Thirst during interdialytic period was significantly frequent during SPHD(37.8 vs 30% 138.1+/-0.5 v 141.1+/-0.6mEq/L, 0.5+/-0.6 v 2.6+/-0.4mEq/L, p<0.05). 3) Day-time, night-time and 24 hour mean systolic BP measured by 24 hour ABPM were significantly higher during SPHD period(149.2+/-4.8, 144.3+/-3.6, 146.6+/-4.1mmHg) than during CHD period(140.1+/-4.8, 133.0+/-4.1, 136.4+/-4.6mmHg, p<0.01). Day-time, night-time and 24 hour mean diastolic BP were also significantly higher during SPHD period(82.6+/-1.5, 84.1+/-1.4, 86.1+/-1.4mmHg) than during CHD period (78.7+/-2.2, 79.6+/-2.3, 81.8+/-2.2mmHg, p<0.05). 4) Systolic load and diastolic load by the criteria of higher than 150/90mmHg throughout the day increased significantly from 21.1+/-7.0 and 18.2+/-6.3% during CHD period to 41.7+/-9.9 and 28.4+/-4.7% during SPHD period. Diurnal difference was not different between the two periods but a significant number of dippers(36.4%) converted to nondipper during SPHD period. Our results shows SPHD increases interdialytic BP and its load. It also adversely alter diurnal variation and dipping status. The additional sodium load and an consequent excessive interdialytic weight gain aassociates with SPHD might contribute to this findings.
Blood Pressure* ; Female ; Humans ; Hypertension ; Hypotension ; Male ; Renal Dialysis* ; Sodium* ; Thirst ; Ultrafiltration ; Weight Gain

The maintenance of the osmolality of body fluids within a very narrow physiologic range is possible by water balance mechanisms that control the intake and excretion of water. Main factors of this process are the thirst and antidiuretic hormon arginine vasopressin (AVP), secretion regulated by osmoreceptors in the hypothalamus. Body water is the primary determinant of the osmolality of the extracellular fluid (ECF), disorders of body water homeostasis can be divided into hypo-osmolar disorders, in which there is an excess of body water relative to body solute, and hyperosmolar disorders, in which there is a deficiency of body water relative to body solute. The sodium is the predominant cation in ECF and the volume of ECF is directly proportional to the content of sodium in the body. Disorders of sodium balance, therefore, may be viewed as disorders of ECF volume. This reviews addresses the regulatory mechanisms underlying water and sodium metabolism, the two major determinants of body fluid homeostasis for a good understanding of the pathophysiology and proper management of disorders with disruption of water and sodium balance.
Arginine Vasopressin ; Body Fluids ; Body Water ; Extracellular Fluid ; Homeostasis ; Hypothalamus ; Osmolar Concentration ; Sodium ; 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*

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

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

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

The antianginal effect of oral nicorandil was examined on 15 subjects with angina pectoris who had not been improved by previous treatment with beta blocker and/or calcium antagonists. Nicorandil, 5mg tid, was added to their previous regimen which were composed of beta blocker and/or calcium antagonists, and patients were followed up at least for 6 weeks. The following results were obtained; 1) Frequences of anginal attack were markedly reduced in 11(73%) of 15 patients after the use of nicorandil. 2) After the use of nicorandil, ST segment depression and T wave inversions were improved in 10(66.7%) of 15 patients. 3) In 10 patients who had been taken nicorandil over 12 weeks, 9 patients showed sustained improvement in clinical status, but no significant side effect was noted. 4) In two patients who had undergone exercise tolerance test, significant prolongation in exercise duration were noted. 5) The adverse effects of nicorandil were as follows; headache in 3, insomnia in 3, excessive perspiration, dizziness, thirst, constipation and facial fiushing in 1, respectively.
Angina Pectoris* ; Calcium ; Constipation ; Depression ; Dizziness ; Exercise Tolerance ; Headache ; Humans ; Nicorandil* ; Sleep Initiation and Maintenance Disorders ; Thirst