Research| Volume 35, ISSUE 2, P193-197, April 2020

Evaluation of a Safety Protocol for the Management of Thirst in the Postoperative Period

Published:December 18, 2019DOI:



      To associate medications, anesthetic techniques, and clinical conditions that interfere in the time of patient approval in the safety protocol for thirst management.


      A quantitative, analytical, and longitudinal study conducted in Southern Brazil.


      A nonprobabilistic sample, of 203 adult patients in the immediate postoperative period, evaluated every 15 minutes for 1 hour.


      A general prevalence of thirst of 67.7%, and mean intensity of 6.38. Fentanyl, morphine, rocuronium, and sevoflurane increased lack of approval in the protocol within 30 minutes (P < .05). General anesthesia (P < .0001) and level of consciousness (95.4%) presented the highest nonapproval rates.


      Anesthetics and general anesthesia delayed protocol approval; however, after 30 minutes, 75.4% of patients had been approved. Level of consciousness was the main criterion of disapproval. The protocol identified crucial clinical conditions that made it impossible for the patient to receive thirst relief strategies and demonstrated that thirst can be satiated precociously with safety.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of PeriAnesthesia Nursing
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Xará D
        • Santos A
        • Abelha F
        Adverse Respiratory Events in a Post-Anesthesia Care Unit.
        Archivos de Bronconeumología (English Edition). 2015; 51: 69-75
        • Ribeiro MB
        • Peniche ACG
        • Silva ACF
        Complications in the post-anesthesia care unit, risk factors and nursing interventions: an integrative review.
        Rev SOBECC. 2017; 22: 218-229
        • Silva LCJR
        • Aroni P
        • Fonseca LF
        I am thirsty! Experience of the surgical patient in the perioperative period.
        Rev SOBECC. 2016; 21: 75-81
        • Silva R.P.J.
        • Rampazzo A.R.P.
        • Nascimento L.A.
        • Fonseca L.F.
        Discomfort patients expect and experience in the immediate postoperative period.
        Rev Baianaenferm. 2018; 32: e26070
        • Pierotti I
        • Fracarolli IFL
        • Fonseca LF
        • Aroni P
        Evaluation of the intensity and discomfort of perioperative thirst.
        Esc Anna Nery. 2018; 22: e20170375
        • Martins PR
        • Fonseca LF
        Assessment of the thirst dimension: integrative review.
        Rev Eletr Enf. 2017; 19: a09
        • Cho E.A.
        • Kim K.H.
        • Park J.Y.
        Effects of frozen gauze with normal saline and ice on thirst and oral condition of laparoscopic cholecystectomy patients: Pilot study.
        J Korean Acad Nurs. 2010; 40: 714-723
        • Conchon MF
        • Nascimento LA
        • Fonseca LF
        • Aroni P
        Perioperative thirst: an analysis from the perspective of the Symptom Management Theory.
        Rev Esc Enferm USP. 2015; 49: 122-128
        • Arai S.R.
        • Butzlaff A.
        • Stotts N.A.
        • Puntillo K.A.
        Quench the thirst: lessons from clinical thirst trials.
        Biol Res Nurs. 2014; 16: 456-466
        • Campana M.C.
        • Fonseca L.F.
        • Lopes D.F.M.
        • Martins P.R.
        Perceptions of caregivers about surgical children's thirst.
        Rev Rene. 2015; 16: 799-808
        • Nascimento L.A.
        • Fonseca L.F.
        • Rosseto E.G.
        • Santos C.B.
        Development of a safety protocol for management thirst in the immediate postoperative period.
        Rev Esc Enferm USP. 2014; 48: 834-843
        • Nascimento L.A.
        • Fonseca L.F.
        • Santos C.B.
        Inter-rater reliability testing of the safety protocol for thirst management.
        J Perianesth Nurs. 2018; 33: 527-536
        • Rocha RG
        • Almeida EG
        • Carneiro LMM
        • Almeida NF
        • Vilas Boas WW
        • Gomez RS
        Anesthesia recovery comparison between remifentanil-propofol and remifentanil-desflurane guided by Bispectral Index® monitoring.
        Rev Bras Anestesiol. 2017; 67: 500-507
        • Stewart P.A.
        • Liang S.S.
        • Li Q.S.
        • et al.
        The impact of residual neuromuscular blockade, oversedation, and hypothermia on adverse respiratory events in a postanesthetic care unit: A prospective study of prevalence, predictors, and outcomes.
        Anesth Analg. 2016; 123: 859-868
        • Conchon M.F.
        • Fonseca L.F.
        Efficacy of an ice popsicle on thirst management in the immediate postoperative period: a randomized clinical trial.
        J Perianesth Nurs. 2018; 33: 153-161
        • Garcia AKA
        • Fonseca LF
        • Aroni P
        • Galvão CM
        Strategies for thirst relief: integrative literature review.
        Rev Bras Enferm. 2016; 69: 1215-1222
        • Serato VM
        • Fonseca LF
        • Birolim MM
        • et al.
        Package of menthol measures for thirst relief: a randomized clinical study.
        Rev Bras Enferm. 2019; 72: 631-639
        • Zimmerman C.A.
        • Lin Y.-C.
        • Leib D.E.
        • et al.
        Thirst neurons anticipate the homeostatic consequences of eating and drinking.
        Nature. 2016; 537: 680-684
        • McKemy D.D.
        • Neuhausser W.M.
        • Julius D.
        Identification of a cold receptor reveals a general role for TRP channels in thermosensation.
        Nature. 2002; 416: 52-58
        • Eccles R.
        • Du-Plessis L.
        • Dommels Y.
        • Wilkinson J.E.E.
        Cold pleasure. Why we like ice drinks, ice-lollies and ice cream.
        Appetite. 2013; 71: 357-360
        • Oliveira S.T.
        • Nascimento L.A.
        • Fonseca L.F.
        Protocolo de segurança de manejo da sede: associação dos critérios de segurança não atingidos com a periodicidade de sua aplicação.
        Anais Eletrônico IX EPCC. 2015; 9: 4-8
        • Garcia A.K.A.
        • Galhardo V.G.
        • Fonseca L.F.
        • Alves M.F.
        Relato de experiência: implantação do Protocolo de Manejo da Sede em Sala de Recuperação Anestésica.
        (Anais do 12° Congresso Brasileiro de Enfermagem em Centro Cirúrgico, Recuperação Anestésica e Centro de Material e Esterilização)2015 (set 22-25; São Paulo)
        • Ludlow C.L.
        Laryngeal reflexes: physiology, technique, and clinical use.
        J Clin Neurophysiol. 2015; 32: 284-293
        • Oliveira A.C.M.
        • Friche A.A.L.
        • Salomão M.S.
        • Bougo G.C.
        • Vicente L.C.C.
        Predictive factors for oropharyngeal dysphagia after prolonged orotracheal intubation.
        Braz J Otorhinolaryngol. 2018; 84: 722-728
        • Veiga-Gil L
        • Pueyo J
        • López-Olaondo L
        Postoperative nausea and vomiting: physiopathology, risk factors, prophylaxis and treatment.
        Rev Esp Anestesiol Reanim. 2017; 64: 223-232
        • Radke O.C.
        • Biedler A.
        • Kolodzie K.
        • Cakmakkaya O.S.
        • Silomon M.
        • Apfel C.C.
        The effect of postoperative fasting on vomiting in children and their assessment of pain.
        Paediatr Anaesth. 2009; 19: 494-499
        • Chauvin C.
        • Schalber-Geyer A.S.
        • Lefebvre F.
        • et al.
        Early postoperative oral fluid intake in paediatric day case surgery influences the need for opioids and postoperative vomiting: A controlled randomized trial.
        Br J Anaesth. 2017; 118: 407-414
        • Wu M
        • Yang L
        • Zeng X
        • et al.
        Safety and feasibility of early oral hydration in the postanesthesia care unit after laparoscopic cholecystectomy: A prospective, randomized, and controlled study.
        J Perianesth Nurs. 2019; 34: 425-430
        • Shim H
        • Gan TJ
        Side effect profiles of different opioids in the perioperative setting: Are they different and can we reduce them?.
        Br J Anaesth. 2019; 123: 266-268
        • Kraychete DC
        • Garcia JBS
        • Siqueira JTT
        Recommendations for the use of opioids in Brazil: Part IV. Adverse opioid effects.
        Rev Dor. 2014; 15: 215-223
        • Yang M.
        • Yu Y.
        • Liu Q.
        Analgesic effects of sevoflurane and isoflurane on elderly patients with colon cancer and their influences on immunity and postoperative cognitive function.
        Iran J Public Health. 2019; 48: 444-450
        • Juhász M.
        • Molnár L.
        • Fülesdi B.
        • et al.
        Effect of sevoflurane on systemic and cerebral circulation, cerebral autoregulation and CO2 reactivity.
        BMC Anesthesiol. 2019; 19: 109
        • Tomal CRG
        • Silva AGPD
        • Yamashita AM
        • et al.
        Assessment of induction, recovery, agitation upon awakening, and consumption with the use of two brands of sevoflurane for ambulatory anesthesia.
        Rev Bras Anestesiol. 2012; 62: 154-172