Mini-mint ice cubes for early postoperative thirst relief in orthopedic patients undergoing general anesthesia: a randomized controlled trial

Postoperative thirst affects 70% of surgical patients, causing discomfort and potential complications, especially in orthopedic patients. Current relief strategies remain suboptimal. This trial evaluated the efficacy and safety of mini-mint ice cubes (1 cm³, 20% mint) for early postoperative thirst relief. 282 patients were randomized to three groups: mini-mint ice cubes, room temperature water or absolute fasting. Primary outcome was thirst intensity at PACU discharge, measured by Numerical Rating Scale. Secondary outcomes included PACU stay, oropharyngeal discomfort, satisfaction, 24-hour postoperative quality of recovery (QoR-15), postoperative nausea and vomiting (PONV), delirium and adverse events. Mini-mint group had lower thirst (median [IQR]: 3 [1-5]) vs. water (4 [2-5], median difference: -1, 95% CI: -2 to 0; P = 0.004); vs. absolute fasting (7 [5-9], median difference: -4, 95% CI: -5 to -3; P < 0.001), shorter PACU stay (35 [30-43] min) vs. water (40 [33-45] min, P = 0.014); vs. absolute fasting (40 [35-55] min, P < 0.001), less oropharyngeal discomfort (12.9% vs. absolute fasting 27.2%, P = 0.015), higher satisfaction (4 [4-5]) vs. water (4 [4-5], P = 0.003) and absolute fasting (3 [2-4], P < 0.001), higher QoR-15 (124 [119-130]) vs. water (119 [114-125], P < 0.001) and absolute fasting (117 [111-123], P < 0.001). PONV, delirium, and hypoxemia showed no intergroup differences; cough occurred only in the water group (6.4%). Mini-mint ice cubes safely and effectively alleviate early postoperative thirst in orthopedic patients under general anesthesia, conferring clinically meaningful benefits compared to absolute fasting. Compared to room temperature water, the improvement is modest with uncertain clinical relevance. Clinical trial registration number: ClinicalTrials.gov (ChiCTR2400089335, 6/9/2024).