RESUMO
AIMS AND OBJECTIVES: To compare mentholated popsicle with usual care (absolute fasting) in the change of thirst intensity and discomfort of patients in the preoperative fasting. BACKGROUND: Thirst is defined as the desire to drink water, and it is considered to be a multifactorial symptom. In the preoperative fasting, the patient may experience intense thirst, often for a long time, that can lead to feelings of suffocation, desperation, fear and anxiety. DESIGN: A randomised controlled trial. METHODS: Forty patients, aged between 18-60 years, were randomised to mentholated popsicle group or absolute fasting group (twenty in each). The primary outcomes were thirst intensity, evaluated by a numeric scale ranging from 0 (no thirst)-10 (the worst possible thirst), and discomfort from thirst (evaluated by the Perioperative Thirst Discomfort Scale), both measured twice (baseline and after 20 min of intervention). The CONSORT checklist was used to report this study. RESULTS: Mean age was similar in both groups (38 years in the mentholated popsicle group and 39 in the absolute fasting group). At baseline, the mentholated popsicle group had higher median for the scales of intensity (6.5) and discomfort (7.5) from thirst than the absolute fasting group (5.0 and 5.0, respectively). At the end of 20 min, the popsicle group had a statistically significant decrease in intensity and discomfort from thirst (median decreases of 5.0 and 7.0 points, respectively) when compared to the absolute fasting group (median increases of 0.5 and 1.0 points, respectively). CONCLUSIONS: The use of mentholated popsicle decreased the intensity and discomfort from thirst, and it is a viable strategy for the management of thirst in the preoperative fasting. RELEVANCE TO CLINICAL PRACTICE: In the preoperative fasting, making mentholated popsicles available to patients is an easy strategy to manage thirst, which might lead to better care.
Assuntos
Gelo , Mentol/administração & dosagem , Cuidados Pré-Operatórios/enfermagem , Sede/efeitos dos fármacos , Adolescente , Adulto , Idoso , Jejum/fisiologia , Jejum/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
The aim of the present study was to determine whether the TRPV1 channel is involved in the onset of sodium appetite. For this purpose, we used TRPV1-knockout mice to investigate sodium depletion-induced drinking at different times (2/24 h) after furosemide administration combined with a low sodium diet (FURO-LSD). In sodium depleted wild type and TRPV1 KO (SD-WT/SD-TPRV1-KO) mice, we also evaluated the participation of other sodium sensors, such as TPRV4, NaX and angiotensin AT1-receptors (by RT-PCR), as well as investigating the pattern of neural activation shown by Fos immunoreactivity, in different nuclei involved in hydromineral regulation. TPRV1 SD-KO mice revealed an increased sodium preference, ingesting a higher hypertonic cocktail in comparison with SD-WT mice. Our results also showed in SD-WT animals that SFO-Trpv4 expression increased 2 h after FURO-LSD, compared to other groups, thus supporting a role of SFO-Trpv4 channels during the hyponatremic state. However, the SD-TPRV1-KO animals did not show this early increase, and maybe as a consequence drank more hypertonic cocktail. Regarding the SFO-NaX channel expression, in both genotypes our findings revealed a reduction 24 h after FURO-LSD. In addition, there was an increase in the OVLT-NaX expression of SD-WT 24 h after FURO-LSD, suggesting the participation of OVLT-NaX channels in the appearance of sodium appetite, possibly as an anticipatory response in order to limit sodium intake and to induce thirst. Our work demonstrates changes in the expression of different osmosodium-sensitive channels at specific nuclei, related to the body sodium status in order to stimulate an adequate drinking.
Assuntos
Apetite/genética , Encéfalo/metabolismo , Dieta Hipossódica , Sódio na Dieta/administração & dosagem , Canais de Cátion TRPV/fisiologia , Animais , Apetite/efeitos dos fármacos , Dieta Hipossódica/efeitos adversos , Ingestão de Líquidos/efeitos dos fármacos , Ingestão de Líquidos/genética , Ingestão de Alimentos/efeitos dos fármacos , Ingestão de Alimentos/genética , Furosemida/farmacologia , Masculino , Camundongos , Camundongos da Linhagem 129 , Camundongos Endogâmicos C57BL , Camundongos Knockout , Sódio na Dieta/metabolismo , Canais de Cátion TRPV/genética , Canais de Cátion TRPV/metabolismo , Sede/efeitos dos fármacos , Sede/fisiologiaRESUMO
OBJECTIVE: to evaluate the effectiveness of menthol chewing gum, in the relief of the intensity and discomfort of the surgical patient's thirst in the preoperative period. METHOD: a randomized controlled trial, with 102 patients in the preoperative period, randomized in a control group, with usual care, and an experimental group, which received menthol gum, which was the study treatment variable. The primary clinical outcome was the variation in thirst intensity, evaluated by the Numeral Verbal Scale, and the secondary, the variation of the discomfort of thirst, evaluated by the Perioperative Thirst Discomfort Scale. Mann-Whitney test was used to compare measures between groups. The significance level adopted was of 0.05. RESULTS: menthol chewing gum significantly reduced the intensity (p <0.001), with Cohen's medium-effect d, and thirst discomfort (p <0.001), with a large-effect Cohen's d. CONCLUSION: menthol chewing gum was effective in reducing the intensity and discomfort of preoperative thirst. The strategy proved to be an innovative, feasible and safe option in the use for the surgical patient, in the management of the preoperative thirst, in elective surgeries. NCT: 03200197.
Assuntos
Goma de Mascar , Mentol/farmacologia , Sede/efeitos dos fármacos , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Período Pré-Operatório , Estatísticas não Paramétricas , Adulto JovemRESUMO
OBJECTIVE: To evaluate the effectiveness of the menthol package (lip hydration and ice popsicles) compared to a package of non-menthol measures (lip hydration and ice popsicles) as a way to relieve thirst in patients in the Anesthetic Recovery Room. METHOD: Randomized and parallel trial study, with 120 patients randomized patients in an experimental group - menthol measurements (n=59) and control group - measures without menthol (n = 61). RESULTS: There was a significant (p<0.05) decrease in intensity, hydration, dryness and taste in the oral cavity between the three moments of assessment/intervention in the two groups. The difference was significant in the experimental group for thirst intensity at the second assessment/intervention point (p<0.05) after a single administration of the menthol package. CONCLUSION: There was a reduction in thirst intensity in both groups. Patients who received menthol packages showed a significant decrease in intensity after a single evaluation/intervention time. NCT: 02869139.
Assuntos
Mentol/farmacologia , Sede/efeitos dos fármacos , Adulto , Antipruriginosos/farmacologia , Antipruriginosos/uso terapêutico , Cirurgia Bariátrica/efeitos adversos , Cirurgia Bariátrica/métodos , Brasil , Feminino , Humanos , Modelos Lineares , Masculino , Mentol/uso terapêutico , Pessoa de Meia-Idade , Obesidade/cirurgia , Estatísticas não ParamétricasRESUMO
ABSTRACT Objective: To evaluate the effectiveness of the menthol package (lip hydration and ice popsicles) compared to a package of non-menthol measures (lip hydration and ice popsicles) as a way to relieve thirst in patients in the Anesthetic Recovery Room. Method: Randomized and parallel trial study, with 120 patients randomized patients in an experimental group - menthol measurements (n=59) and control group - measures without menthol (n = 61). Results: There was a significant (p<0.05) decrease in intensity, hydration, dryness and taste in the oral cavity between the three moments of assessment/intervention in the two groups. The difference was significant in the experimental group for thirst intensity at the second assessment/intervention point (p<0.05) after a single administration of the menthol package. Conclusion: There was a reduction in thirst intensity in both groups. Patients who received menthol packages showed a significant decrease in intensity after a single evaluation/intervention time. NCT: 02869139.
RESUMEN Objetivo: Evaluar la efectividad del paquete de medidas mentoladas (hidratación labial y picolé de hielo) comparado a un paquete de medidas no mentoladas (hidratación labial y picolé de hielo) como un método de alivio de la sed en pacientes en la Sala de Recuperación Post-Anestésica. Método: En un ensayo clínico aleatorizado, paralelo, 120 pacientes aleatorizados en un grupo experimental - medidas mentoladas (n=59) y un grupo control - medidas sin el mentol (n=61). Resultados: Hubo una disminución significativa (p<0,05) sobre la intensidad, hidratación, sequedad y gusto en la cavidad oral entre los tres momentos de evaluación/intervención en los dos grupos, indistintamente. La diferencia fue significativa en el grupo experimental para la intensidad de la sed en el segundo momento de la evaluación/intervención (p<0,05) después de una única administración del paquete de medidas mentoladas. Conclusión: Se encontró una reducción de la intensidad de la sed en los dos grupos. Los pacientes que recibieron las medidas mentoladas presentaron una disminución significativa de la intensidad después de un único momento de evaluación/intervención. NCT: 02869139.
RESUMO Objetivo: Avaliar a efetividade do pacote de medidas mentoladas (hidratação labial e picolé de gelo) comparado a um pacote de medidas não mentoladas (hidratação labial e picolé de gelo) como método de alívio da sede em pacientes na Sala de Recuperação Anestésica. Método: Ensaio clínico randomizado, paralelo, 120 pacientes aleatorizados em grupo experimental - medidas mentoladas (n=59) e grupo controle - medidas sem o mentol (n=61). Resultados: Houve diminuição significativa (p<0,05) sobre a intensidade, hidratação, secura e gosto na cavidade oral entre os três momentos de avaliação/intervenção nos dois grupos indistintamente. A diferença foi significativa no grupo experimental para intensidade da sede no segundo momento de avaliação/intervenção (p<0,05) após uma única administração do pacote de medidas mentoladas. Conclusão: Houve redução da intensidade da sede nos dois grupos. Os pacientes que receberam as medidas mentoladas apresentaram diminuição significativa da intensidade após um único momento de avaliação/intervenção. A NCT: 02869139.
Assuntos
Humanos , Masculino , Feminino , Adulto , Sede/efeitos dos fármacos , Mentol/farmacologia , Brasil , Modelos Lineares , Estatísticas não Paramétricas , Cirurgia Bariátrica/efeitos adversos , Cirurgia Bariátrica/métodos , Mentol/uso terapêutico , Pessoa de Meia-Idade , Antipruriginosos/uso terapêutico , Antipruriginosos/farmacologia , Obesidade/cirurgiaRESUMO
OBJECTIVE: To identify and analyze the evidence on the effect of chewing gum on thirst in adults. METHOD: Integrative review, guided by the question: "What is the scientific evidence about the effects of chewing gum on adult's thirst?" LILACS, PubMed, Scopus and Web of Science were the databases consulted. RESULTS: Of a total of 2,414 articles found, 12 papers were selected whose publications varied between 1991 and 2016. The use of chewing gum resulted in increased salivary volume (five studies), xerostomia relief (seven studies), and thirst reduction (four studies). It was not possible to establish the number of chewing gums per day, being frequent the recommendation to use as desired. There was a predominance of studies with patients under dialysis and with cancer. CONCLUSION: Chewing gum is an effective strategy to reduce thirst discomfort in adults.
Assuntos
Goma de Mascar/efeitos adversos , Sede/efeitos dos fármacos , HumanosRESUMO
ABSTRACT Objective: To identify and analyze the evidence on the effect of chewing gum on thirst in adults. Method: Integrative review, guided by the question: "What is the scientific evidence about the effects of chewing gum on adult's thirst?" LILACS, PubMed, Scopus and Web of Science were the databases consulted. Results: Of a total of 2,414 articles found, 12 papers were selected whose publications varied between 1991 and 2016. The use of chewing gum resulted in increased salivary volume (five studies), xerostomia relief (seven studies), and thirst reduction (four studies). It was not possible to establish the number of chewing gums per day, being frequent the recommendation to use as desired. There was a predominance of studies with patients under dialysis and with cancer. Conclusion: Chewing gum is an effective strategy to reduce thirst discomfort in adults.
RESUMEN Objetivo: Identificar y analizar las evidencias en cuanto al efecto de la goma de mascar sobre la sed en adultos. Método: Revisión integrativa, orientada por la cuestión: "¿Cuáles son las evidencias científicas acerca de los efectos de la goma de mascar sobre la sed en adultos?" Las bases de datos consultadas fueron: LILACS, PubMed, Scopus y Web of Science. Resultados: De un total de 2.414 artículos encontrados, se seleccionaron 12 trabajos cuyas publicaciones variaron entre los años 1991 y 2016. El uso de la goma de mascar resultó en el aumento del volumen salivar (cinco estudios), en el alivio de la xerostomía (siete estudios) y en la reducción de la sed (cuatro estudios). No fue posible establecer el número de gomas al día, siendo frecuente la recomendación de utilizarse según lo deseado. Hubo predominio de estudios con pacientes dialíticos y con pacientes con cáncer. Conclusión: La goma de mascar es una estrategia efectiva para reducir la molestia de la sed en adultos.
RESUMO Objetivo: Identificar e analisar as evidências quanto ao efeito da goma de mascar sobre a sede em adultos. Método: Revisão integrativa, norteada pela questão: "Quais são as evidências científicas acerca dos efeitos da goma de mascar sobre a sede em adultos?" As bases de dados consultadas foram: LILACS, PubMed, Scopus e Web of Science. Resultados: De um total de 2.414 artigos encontrados, selecionaram-se 12 trabalhos cujas publicações variaram entre os anos de 1991 e 2016. O uso da goma de mascar resultou no aumento do volume salivar (cinco estudos), no alívio da xerostomia (sete estudos) e na redução da sede (quatro estudos). Não foi possível estabelecer o número de gomas por dia, sendo frequente a recomendação de utilizar-se conforme desejado. Houve predomínio de estudos com pacientes dialíticos e com pacientes oncológicos. Conclusão: A goma de mascar é uma estratégia efetiva para reduzir o desconforto da sede em adultos.
Assuntos
Humanos , Sede/efeitos dos fármacos , Goma de Mascar/efeitos adversosRESUMO
Objetivo avaliar a efetividade da goma de mascar mentolada em aliviar a intensidade e o desconforto da sede do paciente cirúrgico no período pré-operatório. Método ensaio clínico controlado randomizado, com 102 pacientes em período pré-operatório, aleatorizados em grupo-controle, com cuidado usual, e grupo experimental, que recebeu goma de mascar mentolada, a variável de tratamento do estudo. O desfecho clínico primário foi a variação da intensidade da sede, avaliada pela Escala Verbal Numérica, e o secundário, a variação do desconforto da sede, avaliada pela Escala de Desconforto da Sede Perioperatória. Teste de Mann-Whitney foi usado para comparar as medidas entre os grupos. Nível de significância adotado de 0,05. Resultados a goma de mascar mentolada reduziu significativamente a intensidade (p<0,001), com d de Cohen de efeito médio, e o desconforto da sede (p<0,001), com d de Cohen de efeito grande. Conclusão a goma de mascar mentolada mostrou-se efetiva na redução da intensidade e do desconforto da sede pré-operatória. A estratégia mostrou-se uma opção inovadora, viável e segura no uso para o paciente cirúrgico, no manejo da sede pré-operatória, em cirurgias eletivas. NCT: 03200197.
Objective to evaluate the effectiveness of menthol chewing gum, in the relief of the intensity and discomfort of the surgical patient's thirst in the preoperative period. Method a randomized controlled trial, with 102 patients in the preoperative period, randomized in a control group, with usual care, and an experimental group, which received menthol gum, which was the study treatment variable. The primary clinical outcome was the variation in thirst intensity, evaluated by the Numeral Verbal Scale, and the secondary, the variation of the discomfort of thirst, evaluated by the Perioperative Thirst Discomfort Scale. Mann-Whitney test was used to compare measures between groups. The significance level adopted was of 0.05. Results menthol chewing gum significantly reduced the intensity (p <0.001), with Cohen's medium-effect d, and thirst discomfort (p <0.001), with a large-effect Cohen's d. Conclusion menthol chewing gum was effective in reducing the intensity and discomfort of preoperative thirst. The strategy proved to be an innovative, feasible and safe option in the use for the surgical patient, in the management of the preoperative thirst, in elective surgeries. NCT: 03200197.
Objetivo evaluar la efectividad de la goma de mascar mentolada en aliviar la intensidad y la incomodidad de la sed del paciente quirúrgico en el período preoperatorio. Método ensayo clínico controlado aleatorizado, con 102 pacientes en período preoperatorio, aleatorizados en grupo control, con cuidado usual, y grupo experimental, que recibió goma de mascar mentolada, la variable de tratamiento del estudio. El resultado clínico primario fue la variación de la intensidad de la sed, evaluada por la Escala Verbal Numérica, y el secundario, la variación de la incomodidad de la sed, evaluada por la Escala de Desconocimiento de la Sede Perioperatoria. La prueba de Mann-Whitney fue utilizada para comparar las medidas entre los grupos. Nivel de significancia adoptado de 0,05. Resultados la goma de mascar mentolada redujo significativamente la intensidad (p <0,001), con d de Cohen de efecto promedio, y el malestar de la sed (p <0,001), con d de Cohen de efecto grande. Conclusión la goma de mascar mentolada se mostró efectiva en la reducción de la intensidad y de la incomodidad de la sed preoperatoria. La estrategia se mostró una opción innovadora, viable y segura en el uso para el paciente quirúrgico, en el manejo de la sed preoperatoria, en cirugías electivas. NCT: 03200197.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Sede/efeitos dos fármacos , Cuidados Pré-Operatórios , Goma de Mascar , Estatística , Período Pré-Operatório , Mentol/farmacologiaRESUMO
NEW FINDINGS: What is the central question of this study? The central goal of this study was to understand the effects of central angiotensin-(1-7) on basal and osmotically stimulated water intake in rats. What is the main finding and its importance? This study demonstrated that central administration of angiotensin-(1-7) did not induce thirst in basal conditions but increased water intake after osmotic stimulation, such as water deprivation and salt loading. These results indicate a new function for this peptide, which, in turn, allows for future research on the mechanisms through which angiotensin-(1-7) influences osmotic thirst. Angiotensin-(1-7) [Ang-(1-7)] is generated by type 2 angiotensin-converting enzyme (ACE2) and binds to the MAS receptor. Although it is well known that Ang-(1-7) functionally antagonizes the effects of the classical renin-angiotensin system in several situations, the role of Ang-(1-7) in hydromineral homeostasis is not clear. The aim of this study was to assess the role of Ang-(1-7) on neuroendocrine responses to hyperosmolality in rats. Male Wistar rats were divided into the following three groups: control; 24 h of water deprivation (WD); and 24 h of salt loading (SL; 1.8% NaCl). Intracerebroventricular (i.c.v.) injections of Ang-(1-7) or vehicle were given to assess water intake and plasma concentration of vasopressin. Additionally, the brains from control and WD groups were collected to evaluate gene expression in the subfornical organ (SFO), paraventricular nucleus (PVN) and supraoptic nucleus (SON). It was found that i.c.v. Ang-(1-7) did not change water and salt intake in control rats; however, Ang-(1-7) increased water intake after WD and SL, with no change in salt intake. Plasma vasopressin was not changed by i.c.v. Ang-(1-7) in control or WD rats. Moreover, WD increased Mas gene expression in the SON and PVN, with no changes in Ace2 mRNA levels. In conclusion, Ang-(1-7) increases thirst after osmotic stimuli, indicating that a previous sensitization to its action is necessary. This finding is consistent with the increased Mas gene expression in the PVN and SON after water deprivation.
Assuntos
Angiotensina I/administração & dosagem , Ingestão de Líquidos/efeitos dos fármacos , Pressão Osmótica , Núcleo Hipotalâmico Paraventricular/efeitos dos fármacos , Fragmentos de Peptídeos/administração & dosagem , Órgão Subfornical/efeitos dos fármacos , Núcleo Supraóptico/efeitos dos fármacos , Sede/efeitos dos fármacos , Enzima de Conversão de Angiotensina 2 , Animais , Injeções Intraventriculares , Masculino , Núcleo Hipotalâmico Paraventricular/metabolismo , Peptidil Dipeptidase A/genética , Peptidil Dipeptidase A/metabolismo , Proto-Oncogene Mas , Proteínas Proto-Oncogênicas/genética , Proteínas Proto-Oncogênicas/metabolismo , Ratos Wistar , Receptores Acoplados a Proteínas G/genética , Receptores Acoplados a Proteínas G/metabolismo , Cloreto de Sódio/administração & dosagem , Órgão Subfornical/metabolismo , Núcleo Supraóptico/metabolismo , Regulação para Cima , Vasopressinas/sangue , Privação de ÁguaRESUMO
Water-homeostasis is a fundamental physiological process for terrestrial life. In vertebrates, thirst drives water intake, but the neuronal circuits that connect the physiology of water regulation with emotional context are poorly understood. Vasopressin (VP) is a prominent messenger in this circuit, as well as L-glutamate. We have investigated the role of a VP circuit and interaction between thirst and motivational behaviors evoked by life-threatening stimuli in rats. We demonstrate a direct pathway from hypothalamic paraventricular VP-expressing, glutamatergic magnocellular neurons to the medial division of lateral habenula (LHbM), a region containing GABAergic neurons. In vivo recording and juxtacellular labeling revealed that GABAergic neurons in the LHbM had locally branching axons, and received VP-positive axon terminal contacts on their dendrites. Water deprivation significantly reduced freezing and immobility behaviors evoked by innate fear and behavioral despair, respectively, accompanied by decreased Fos expression in the lateral habenula. Our results reveal a novel VP-expressing hypothalamus to the LHbM circuit that is likely to evoke GABA-mediated inhibition in the LHbM, which promotes escape behavior during stress coping.