The Effect of Cold Water Spray Application on Dry Mouth and Thirst Symptoms and Comfort of Patients After Endonasal Endoscopic Surgery After Admission to Intensive Care Unit

The endoscope has been used in surgery for many years due to the favorable factors such as small incision area. In the 1990s, the experience gained in surgery and advances in technology were adapted to endoscopy and new endoscopic approaches were developed in transsphenoidal surgery. Although this method varies according to the type of surgical procedure, the nature and localization of the mass and the decision of the surgeon, it is a method that is now used in neurosurgery.

Studies have shown that pain, various pulmonary, cardiovascular and neurologic symptoms, deterioration in stability, anxiety, nausea and vomiting, insomnia, limitation of movement, thirst and dry mouth are the most common issues that patients experience after surgery. In endonasal endoscopic surgery, preoperative fluid and nutrient restriction and anxiety, intraoperative anesthetic drugs, intubation, surgical procedure, postoperative neuroendocrine response to surgical stress, hormonal irregularities due to pituitary surgery, fluid-electrolyte imbalances, and the tampon placed to stabilize the graft placed between the nose and skull base after the surgical procedure can cause patients to experience severe dry mouth and thirst. These tampons used for graft stabilization can remain in the patient for an average of 5-7 days. This may cause patients to experience more thirst and dry mouth symptoms.

When the literature is examined, it is seen that thirst and dry mouth symptoms experienced by patients and the effectiveness of the interventions have been evaluated in recent years. However, there is no study evaluating thirst and dry mouth symptoms in patients undergoing endonasal endoscopic surgery. It is thought to be important to evaluate the effectiveness of cold water spray application on dry mouth and thirst symptoms, which are thought to affect the comfort levels of patients in this patient group.

Hypotheses of the Study H0.1: Cold water spray application has no effect on dry mouth symptom. H1.1: Cold water spray application has an effect on dry mouth symptom. H0.2: The cold water spray application has no effect on the thirst symptom. H1.2: Cold water spray application has an effect on thirst symptom. H0.3: Cold water spray application has no effect on oral health. H1.3: Cold water spray application has an effect on oral health. H0.4: Cold water spray application has no effect on patient comfort. H1.4: Cold water spray application has an effect on patient comfort. Inclusion criteria

• Patients who agreed to participate in the study,
• Patients over 18 years of age,
• Patients with endonasal endoscopic surgery and nasal tampons,
• Patients who can communicate verbally,
• Patients with a Glasgow Coma Scale score of 15 before and after surgery. Exclusion criteria
• Patients who refused to participate in the study,
• Patients under 18 years of age,
• Patients who require respiratory support after surgical intervention and need intubation,
• Patients undergoing surgery that may interfere with oral assessment,
• Patients with a postoperative Glasgow Coma Scale score of 14 or less,
• Patients with Diabetes Mellitus and Xerostomia. Patient groups Experimental Group: Patients in this group will receive cold water application in the form of a spray (6 times every half hour) and oral care (2 times a day, at 22.00 pm and 07.00 am, using an oral care solution containing 0.25% chlorhexidine gluconate approved by the Ministry of Health and an oral care stick, and moisturizing the lips with a lip moisturizer containing glycerin as the main component).