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Comparative effectiveness of oral cooling and moisturizing interventions for managing postoperative thirst in post-anesthesia care unit patients: A systematic review and network meta-analysis

Int J Nurs Stud. 2026 Jun 15;182:105620. doi: 10.1016/j.ijnurstu.2026.105620. Online ahead of print.

ABSTRACT

BACKGROUND: Postoperative thirst in the post-anesthesia care unit is a common symptom that can have adverse physiological and psychological effects. Although various cooling and moisturizing interventions have been shown to alleviate postoperative thirst, their relative effectiveness remains unclear.

OBJECTIVE: To compare the effects of cooling and moisturizing interventions on postoperative thirst relief in patients in the post-anesthesia care unit.

DESIGN: A systematic review and network meta-analysis.

INFORMATION SOURCES: PubMed, Web of Science, CINAHL, EMBASE, and Scopus were systematically searched from inception to January 16, 2026.

METHODS: Two reviewers independently conducted study screening, quality assessment, and data extraction. A random-effects network meta-analysis was undertaken to compare the relative effects of oral cooling and moisturizing interventions on postoperative thirst.

RESULTS: A total of eleven RCTs involving 3098 participants and eight oral interventions were included. The network meta-analysis showed that, compared with the nil by mouth (NPO) control group (i.e., no oral intake or oral intervention), the interventions showing the largest reductions in postoperative thirst intensity were menthol ice (MD = -4.84; 95% CI, -6.42 to -3.26), followed by ice (MD = -4.17; 95% CI, -5.82 to -2.51) and water (MD = -4.07; 95% CI, -5.36 to -2.78). In contrast, citric acid spray, aromatic solution spray, water spray, wet gauze, and wet cotton swab did not show statistically significant reductions in postoperative thirst intensity.

CONCLUSIONS: Menthol ice, ice, and water emerged as the most promising options for reducing postoperative thirst intensity. However, the current evidence remains limited, and further high-quality studies with standardized protocols are needed to confirm these findings.

REGISTRATION: https://www.crd.york.ac.uk/prospero/ CRD42024610113, registered 4/11/2024.

PMID:42365725 | DOI:10.1016/j.ijnurstu.2026.105620

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