Cold Water Gargling After Major Abdominal Surgery

The Effect of Cold Gargling on Oral Dryness, Thirst Severity, and Patient Satisfaction in Patients Who Have Undergone Major Abdominal Surgery: A Randomized Controlled Trial

This randomized controlled trial examined the effect of cold water gargling on postoperative oral dryness, thirst severity, and patient satisfaction in patients who underwent major abdominal surgery. Patients were randomly assigned to either the intervention group (cold water gargling) or the control group (standard care). Thirst severity and oral dryness were assessed using a Visual Analog Scale (VAS; 0-10) at postoperative 8, 12, and 24 hours. Perioperative thirst-related discomfort was evaluated using the Perioperative Thirst Discomfort Scale (PTDS; score range 0-12), and patient satisfaction was assessed using a VAS (0-10) at postoperative 24 hours. The study was conducted at Erciyes University Faculty of Medicine Gevher Nesibe Hospital, General Surgery Clinic. A total of 88 patients were enrolled (44 per group). The study aimed to provide evidence for a simple, low-cost nursing intervention to improve postoperative patient comfort.

Study Overview

• Status: Completed
• Conditions: Major Abdominal Surgeries
• Intervention / Treatment: Other: Cold water gargling

• Study Type: Interventional
• Enrollment (Actual): 88
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Kayseri
    • Kayseri, Kayseri, Turkey (Türkiye), 38030
      • Erciyes University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Aged 18 years or older
• Scheduled for elective major abdominal surgery
• Able to communicate verbally
• Willing to participate and provided written informed consent
• No restriction on gargling (intact swallowing reflex)

Exclusion Criteria:

• Presence of oral mucositis, oral ulceration, or any oral pathology
• History of dysphagia or swallowing difficulties
• Presence of nausea or vomiting preventing gargling
• Altered level of consciousness or inability to cooperate
• Receiving intravenous fluid therapy that resolves thirst symptoms
• Patients who required reoperation during the study period
• Patients transferred to the intensive care unit postoperatively

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control group; Patients in the control group received standard postoperative care per hospital protocol. No gargling intervention was applied. Oral intake restrictions were maintained as per routine clinical practice.
Other: Intervention group; Patients in the intervention group gargled with cold water (approximately 10 mL, 4°C) for 30 seconds at postoperative 8, 12, and 24 hours. Gargling was performed under nurse supervision. Patients were instructed not to swallow the water.	Other: Cold water gargling; Patients gargled with cold water at postoperative 8, 12, and 24 hours. Each gargling session involved approximately 10 mL of cold water (approximately 4°C) for 30 seconds. The procedure was performed under nurse supervision. Patients were instructed not to swallow the water and to spit it out after gargling. No oral fluid intake was permitted during the study period per standard postoperative protocol.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Thirst Severity	Assessed using a Visual Analog Scale (VAS; 0=no thirst, 10=very severe thirst)	Postoperative 8, 12, and 24 hours
Oral Dryness Severity	Assessed using a Visual Analog Scale (VAS; 0=no oral dryness, 10=very severe oral dryness)	Postoperative 8, 12, and 24 hours

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Perioperative Thirst-Related Discomfort	Assessed using the Perioperative Thirst Discomfort Scale (PTDS; Turkish version). 6-item, 3-point Likert scale. Total score range 0-12; higher scores indicate greater discomfort.	Postoperative 24 hours
Patient Satisfaction	Assessed using a Visual Analog Scale (VAS; 0=not satisfied at all, 10=very satisfied)	Postoperative 24 hours

Collaborators and Investigators

• Sponsor: TC Erciyes University

Study record dates

Study Major Dates

• Study Start (Actual): March 19, 2025
• Primary Completion (Actual): March 1, 2026
• Study Completion (Actual): March 1, 2026

Study Registration Dates

• First Submitted: March 26, 2026
• First Submitted That Met QC Criteria: March 26, 2026
• First Posted (Actual): April 1, 2026

Study Record Updates

• Last Update Posted (Actual): April 6, 2026
• Last Update Submitted That Met QC Criteria: March 31, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: ErciyesUniversity_

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No