Sensory analysis of menthol and lemon popsicles for thirst management in surgical patients

Carla Brandão de Oliveira¹, Aline Korki Arrabal Garcia Massardi², Leonel Alves do Nascimento³, Marília Ferrari Conchon⁴, Paulo de Tarso Carvalho⁵, Lígia Fahl Fonseca⁶

^1,2,3,4,6State University of Londrina. Londrina (PR), Brazil.

⁵Federal University of Technology. Londrina (PR), Brazil.

Introduction

Innovation in healthcare constitutes a fundamental element to promote improvements and significant impacts in patient care. The initial step for introducing new products to the market, especially in the food industry, involves strategies and tools that enable pre-assessment of the product so that, upon reaching the target audience, rejection is avoided.^1,2 Among strategies employed by the food industry, sensory analysis is recognized as a tool aimed primarily at eliciting and measuring product quality and consumer acceptance. It acknowledges individual responses to food stimuli, being influenced by memory, experiences, preferences, and cultural factors.^1,3

A novel product with an innovative healthcare purpose is under development to mitigate thirst in patients under varied conditions. Perioperative thirst is a multifactorial symptom present in most surgical patients, yet it remains undervalued from healthcare professionals’ perspective. It has high prevalence, 72.7% in adults and 88.5% in children, demonstrating the importance of identifying and treating the symptom. However, in most institutions, the belief persists that thirst is a price to be paid for safe surgery.^4,5 As an innovative product, it directly impacts care processes, assisting professionals in decision-making when facing patients with thirst, as well as in symptom relief.⁶

In this context, a group of researchers has worked to produce evidence regarding thirst management and to awaken healthcare professionals’ intentional focus on a prevalent perioperative symptom, as well as in other patients with fluid restrictions such as burn victims, critical patients, and those with chronic kidney disease. The Thirst Study and Research Group (Grupo de Estudo e Pesquisa da Sede, GPS) has been demystifying concepts and paradigms related to fluid intake perioperatively to contribute to quality care for surgical patients, minimizing their thirst and discomfort.

MMS, implemented in some Brazilian hospitals, uses as the main cold strategy a handmade ice popsicle, which poses barriers to institutional adoption. To facilitate popsicle use, especially by institutions, a menthol-based formulation was developed, alongside analysis of its rheological properties. This popsicle exhibits prolonged melting time, allowing extended cold receptor stimulation in the oral cavity. Moreover, menthol in the formulation aims to activate Transient Receptor Potential Melastatin 8 (TRPM8) receptors, known to exist throughout the gastrointestinal tract, which activate preabsorptive satiety, permitting individuals to feel satiated with small volume ingestion.⁹

Thus, this study aimed to perform sensory analysis of menthol popsicle samples with different lemon concentrations by healthy assessors and preoperative patients.

Method

This study adopted a qualitative descriptive approach for attribute identification tests and a quantitative approach for the remaining tests, utilizing affective methods defined as tests designed to verify consumer acceptance and preference for a product.¹ Sensory analysis of the popsicles was conducted in four stages: attribute identification and descriptive ranking analysis; application of the preference test; application of acceptance and purchase intention tests with healthy volunteers; and application of acceptance and purchase intention tests with preoperative patients.

Popsicle preparation

The menthol popsicle base formulation was developed, and its ingredients remain confidential due to a pending patent application. The base formulation for study tests was prepared by a compounding pharmacy.

Consumers tend to develop affection toward specific product classes, associating consumption with aromas, colors, odors, and tastes. Regarding the popsicle, consumers generally associate it with refreshment, lightness, and a flavor recognized through affective memory, such as lemon.

For the addition of coloring and flavoring agents, extensive market research was conducted to identify a product free from sugars and preservatives. The choice fell on green liquid food coloring (water, ethyl alcohol, and artificial dyes Tartrazine Yellow (INS102), Brilliant Blue (INS133), and Indigotine Blue (INS132)), supplied in 10 mL packages, and artificial food-grade essence identical to natural Sicilian lemon flavor in 30 mL packaging, containing artificial aromatic base diluted in water and neutral ethyl alcohol, both from the brand “Arcolor”, to provide a flavor commonly recognized by edible ice consumers, attractive and well accepted.¹⁰ For the tests, three samples were produced with different concentrations of artificial lemon essence: popsicle A (0.5%), popsicle B (0.7%), and popsicle C (1.2%).

After formulation preparation, the solution was placed into silicone molds with a cylindrical shape, each 20 milliliters (mL), and frozen at -18ºC. After thirty minutes of freezing, a plastic stick was inserted into the popsicle to ensure it would be fixed during freezing, facilitating handling and tasting.

Sensory analysis with healthy volunteers

The study employed sensory analysis using qualitative descriptive methods for the descriptive ranking test and subjective or affective methods for preference and acceptance tests with purchase intention. All tests took place in the sensory analysis laboratory of the State University of Londrina (UEL). The research was previously submitted to UEL’s Research Ethics Committee under opinion 3.786.016 and CAAE 26118419.2.0000.5231. Research adhered to Brazilian and international ethical standards. All participants were informed about the study and signed the Free and Informed Consent Form.

The assessors received no prior training nor contact with the product or evaluation forms. Instructions were provided minutes before participation. Inclusion criteria comprised individuals of both genders aged 18 to 60 years, self- and allo-psychically oriented, assessed through the following questions: What is your name? Do you know where you are? What is today’s date? Exclusion criteria included self-reported olfactory or gustatory dysfunction, smokers, and pregnant women.

The first test aimed to identify popsicle attributes using 21 untrained assessors; term collection used the Rede Method.¹⁰ On the first day, 21 untrained assessors received two popsicle samples with 0.5% (popsicle A) and 1.2% (popsicle C) concentrations. Samples were coded with random three-digit numbers. Assessors also received water and salt crackers and were instructed to consume a piece between samples to neutralize the palate. They were asked to evaluate popsicles from left to right, indicating similarities and differences regarding color, flavor, aroma, and texture attributes. Most frequently cited descriptors were used to create the attribute difference ranking test script.

Next, the attribute difference ranking test was conducted at the sensory laboratory by the same 21 untrained assessors. They received three popsicle samples with different lemon essence concentrations: 0.5% (popsicle A), 0.7% (popsicle B), and 1.2% (popsicle C). Each 20 mL sample was served in a plastic cup, coded with three-digit numbers, and offered randomly. Water and salt crackers were provided to neutralize the palate between samples. After being instructed to taste popsicles from left to right, they ordered samples according to intensity (from low to high) of each attribute (green color, lemon flavor, mint flavor, and mint residual flavor).

The third test was a preference test with 60 untrained healthy volunteers. Participant number was established according to Brazilian Association of Technical Standards (Associação Brasileira de Normas Técnicas, ABNT) recommendations.¹¹ The data collection instrument included questions regarding participant popsicle consumption frequency and preference for lemon-flavored popsicles. Each assessor received three popsicle samples with varying lemon flavor concentrations: 0.5% (popsicle A), 0.7% (popsicle B), and 1.2% (popsicle C). Samples were coded randomly with three-digit numbers and served in plastic cups. Water and salt crackers were provided to neutralize the palate between samples. After tasting popsicles left to right, participants evaluated global preference aiming to identify the most preferred popsicle among the options. Evaluation proceeded in ascending order.

The acceptance test involved 60 untrained healthy volunteers, distinct from volunteers in previous tests. Participant number followed ABNT recommendations.¹¹ Each assessor received the three popsicle samples with 0.5%, 0.7%, and 1.2% lemon flavor concentrations. Each 20 mL sample was coded randomly and served in plastic cups. Water and salt crackers were provided to neutralize palate between samples. After tasting, assessors rated their liking or disliking regarding color, aroma, flavor, texture, and overall impression using a seven-point facial scale (1=disliked very much, 7=liked very much).¹² Acceptability indexes were calculated considering attributes with scores above 70% as accepted.¹³ 

Sensory analysis with preoperative patients

This stage was conducted with patients from two hospitals in southern Brazil. One is a tertiary teaching hospital, a regional reference center performing a mean of 640 surgeries per month. The other is a secondary hospital, performing about 150 surgeries per month.

Inclusion criteria comprised individuals of both genders aged 18 to 60 years, fasting for at least three hours, and available two hours before surgery. Exclusion criteria included patients with self-reported olfactory or gustatory dysfunctions, smokers, or pregnant women, noted in self-report or medical records.

Sample size calculation was based on tables considering Type I and Type II errors, experimental standard deviation (s), and sensory scale mean differences (d). For use of a nine-point hedonic scale, targeting α=5% and β=10%, a sample size of 112 consumers was indicated.¹⁴

For sensory analysis with patients, results of acceptance tests with healthy volunteers were considered. As no popsicle showed statistically higher preference or acceptance, the popsicle with the highest acceptability index in the flavor attribute was selected: the 0.5% lemon essence concentration popsicle (popsicle A).

Patients received 20 mL popsicle samples in small plastic cups. After tasting, they rated liking or disliking regarding color, aroma, flavor, texture, and overall impression using the seven-point facial scale (1=disliked very much, 7=liked very much).¹³ Refusals were measured and recorded. Acceptability indexes considered attributes with ratings above 70% as accepted.^1,14

Statistical analysis

Data from the preference ranking test were analyzed using the Friedman test, applying Newell & Macfarlane (1987) tables. Analysis of variance was applied for preference tests. Acceptance tests with patients (popsicle A) involved central tendency measures and Wilcoxon test according to data distribution. All tests considered a 5% significance level. Analyses were performed using R software version 4.0.2 (2020).

Acceptability index (AI%) for each attribute was calculated by the formula:^1,14 AI% = X.100/N (where X is the mean score of each sample and N is the maximum score assigned by tasters.). 

Results

The descriptive ranking analysis test was applied to 21 untrained assessors, aiming to identify the primary descriptors of the popsicle for the following attributes: appearance, aroma, flavor, texture, and aftertaste. The sample comprised four assessors aged between 18 and 25 years, nine between 26 and 35 years, six between 36 and 45 years, one between 45 and 55 years, and one between 56 and 60 years. The majority belonged to the age group between 26 and 35 years (42.8%) and identified as female (80.9%). The main attributes described by the assessors were green color (14 assessors), lemon flavor (11 assessors), mint flavor (11 assessors), and mint residual flavor (13 assessors). These attributes were used for subsequent evaluation through the ranking test.

The preference ranking test sample, consisting of 60 healthy volunteers, was primarily composed of individuals aged 18 to 35 years (76.6%). Age groups comprised 40.6% between 18 and 25 years, 21.6% between 26 and 35 years, 10% between 36 and 45 years, and 3.3% between 46 and 55 years. Regarding gender, females predominated (65%). Results for the ranking and preference tests are presented in Table 1.

Table 1 - Results from sensory ranking tests of three lemon-flavored popsicle formulations for thirst treatment. Londrina (PR), Brazil, 2024.

Attribute Difference*		A (0.5%)	B (0.7%)	C (1.2%)
Green color		50ª	22b	54ª
Lemon flavor		42ª	36ª	48ª
Mint flavor		37ª	44ª	45ª
Mint residual flavor		42ª	43ª	41ª
Preference**		127ª	111ª	120ª

*Means followed by the same letter within the row do not differ significantly (p ≤ 0.05) by Friedman test. Minimum difference in sums * ≥19 (sample of 21 assessors); **≥32 (sample of 60 assessors).

Results from the ranking difference test (Table 1) indicate that assessors did not perceive differences among the three samples during the test for the attributes lemon flavor, mint flavor, and mint residual flavor. However, for green color, participants indicated sample B as the lightest. The preference test (Table 1), conducted with 60 assessors, confirmed the indication of the ranking test, finding no statistical differences among the three samples; in other words, no sample was preferred more than the others.

In the third stage, an acceptance test was conducted with 60 healthy volunteers. The predominant age group was 18 to 35 years (62.3%), followed by 40.6% between 18 and 25 years, 21.6% between 26 and 35 years, and 3.3% between 46 and 55 years, with female predominance (75%). Characterization of assessors revealed that regarding lemon-flavored popsicle consumption and preference, most (98.3%) reported liking lemon popsicles, with mean consumption approximately once per month. Results of acceptance tests with 60 healthy volunteers presented means for attributes “color” and “texture” above 5 (on the hedonic scale), indicating satisfactory outcomes, shown in Table 2.

Regarding data in Table 2, attributes “aroma” and “overall impression” had means below 5, showing a neutral consumer evaluation. The “flavor” attribute presented a mean below the neutral point on the scale (<4).

Table 2 - Results of acceptance sensory test for lemon-flavored popsicle samples evaluated by untrained healthy volunteers. Londrina (PR), Brazil, 2024.

		N	Mean	Standard deviation	(AI%)
Popsicle Color	Popsicle A	60	5.50	1.097	78.5
	Popsicle B	60	5.45	1.185	77.8
	Popsicle C	60	5.70	1.046	81.4
Popsicle Aroma	Popsicle A	60	4.50	1.308	64.2
	Popsicle B	60	4.55	1.241	65
	Popsicle C	60	4.90	1.362	70
Popsicle Flavor	Popsicle A	60	3.85	1.655	55
	Popsicle B	60	3.47	1.631	49.4
	Popsicle C	60	3.67	1.398	52.2
Popsicle Texture	Popsicle A	60	5.40	1.417	77.1
	Popsicle B	60	5.12	1.342	73
	Popsicle C	60	5.20	1.505	74.2
Overall Impression	Popsicle A	60	4.56	1.405	65.1
	Popsicle B	60	4.32	1.357	61.7
	Popsicle C	60	4.47	1.295	63.7

*N = Sample size, Mean = acceptance test result. ^‡AI = Acceptability index.

Table 2 shows acceptability index results, indicating that in tests with healthy volunteers, attributes “color” and “texture” received means above 70%. Additionally, attributes “aroma” and “overall impression” showed percentages above 60%, with popsicle C reaching 70%. Flavor was the attribute with the lowest acceptability percentages, ranging from 49% to 55%.

In the analysis with preoperative patients, the sample of 118 patients was mostly male (56.7%), with a mean age of 40 years, who reported liking lemon popsicles (84.7%), and who consumed the entire popsicle offered in the study (75.4%). Table 3 presents sample characterization and popsicle acceptability data. Most participants (89) consumed the entire 20 mL popsicle. Among those who refused (29), the refused volume was measured, with a mean of 7.1 mL.

Table 3 - Distribution of characteristics and consumption among patients participating in the acceptability test of popsicle A (0.5%) (n=118). Londrina (PR), Brazil, 2024.

Variable		N	%			CI* 95%
Gender
Female		51	43.22			34.3-52.2
Male		67	56.78			47.8-65.7
Likes Lemon Popsicle?
Yes		100	84.75			77.2-90.1
No		18	15.25			09.9-22.8
Consumed Entire Popsicle?
Yes		89	75.42			66.9-82.3
No		29	24.58			17.7-33.6
Variable	Mean	Standard Deviation		Median	IQR‡		p-value§
Age	40.77	12.31		42.50	20.00		< 0.001
Popsicle Refused Volume (n=29)	7.10	2.66		8.00	3.00		0.239

*95% CI = Confidence Interval ^‡IQR = Interquartile Range ^§p-value = Shapiro-Wilk test.

Of the 118 preoperative patients, 29 refused parts of the popsicle (Table 3). The mean refused volume was 7.10 mL, with the popsicle being 20 mL. When questioned about refusal reasons, patients mentioned bitterness (4 patients), bad taste (3 patients), and absence of sugar (10 patients). Among the interviewed sample, 18 reported disliking the popsicle.

In relation to the acceptance test, no difference was found in preference among attributes. Means equal to or above five on the seven-point hedonic scale correspond to liked, liked very much, and liked extremely. Therefore, means above this threshold were considered satisfactory. Flavor was the attribute with means below five, ranging between four (neutral) and five (liked). Data are presented in Table 4.

Table 4 - Attributes evaluated for acceptance of popsicle A (0.5%) for thirst management in preoperative patients (n = 118). Londrina (PR), Brazil, 2024.

Attribute	Mean	Standard Deviation	Median	IQRa	p-valueb	Effect SizeC	Acceptability Index (AI%)
Color	6.04	1.11	6.00	2.00	< 0.001	0.82	86.2
Aroma	5.24	1.65	6.00	3.00	0.061	0.18	74.8
Flavor	4.75	1.60	5.00	2.00	0.888	-0.15	67.8
Texture	5.63	1.37	6.00	2.00	< 0.001	0.56	80.4
Overall Impression	5.47	1.40	6.00	2.00	<0.001	0.43	78.1

^a IQR = Interquartile Range ^b Wilcoxon test – Hₐ μ > 5 ^c Biserial correlation order ^d Wilcoxon test – Hₐ μ > 4.

Acceptability results from patients demonstrated only the flavor attribute presented a percentage below 70%, close to 67.85%. These results indicate, from a general view, acceptance of the popsicle attributes by assessors, with color and texture acceptability percentages above 80%.

Acceptability of popsicle A (0.5%) was tested both by volunteers and preoperative patients. Results identified flavor as the attribute with the lowest means (3.85 and 4.75) in both groups. However, evaluation means were higher in tests performed with patients (Figure 1).

Figure 1 - Acceptance tests for popsicle A. Healthy volunteers versus surgical patients. Londrina (PR), Brazil, 2024.

Discussion

The study and evaluation of cold and mentholated strategies for thirst relief and its symptoms are essential and permeated the entire course of this research. Although the focus of this study was sensory analysis, the effectiveness of cold strategies with menthol presence was decisive in the differences in acceptance between volunteers and patients in the tests. Other findings corroborate those already mentioned, with studies testing solid and cold strategies compared to liquids at room temperature concluding that popsicles, a combination of solid texture, cold temperature, and flavor components with menthol and lemon, performed better in quenching thirst.¹⁵

 Understanding popsicle acceptance among both healthy volunteers and patients experiencing thirst was crucial, as information obtained from the tests contributes to the development of the popsicle as a product.

The preference test applied to volunteers showed differences in preference for the color of popsicle B compared to popsicles A and C. This result is singular, as no different dye dosages were used in the formulations, and literature offers no evidence that lemon flavor concentrate interferes with color sensory perception. In other results from Table 1, no differences were observed regarding preference for the lemon flavor, mint flavor, and mint residual flavor attributes.

In relation to the lemon flavor, no differences were found among samples, indicating that variations in lemon flavor concentrate were imperceptible among assessors. A similar finding was reported in a study using lower sodium concentrations in pizza dough, aiming to offer healthier options. Samples with usual sodium concentration and those with 31% less sodium were compared. Flavor acceptance results showed no statistically significant differences between samples.¹⁶

As the results from the preference test (Table 1) demonstrated that healthy assessors did not indicate a product with superior results compared to others, it was decided to evaluate the acceptance of the popsicles by volunteers through an acceptance test.

Acceptance test results with healthy assessors indicated that flavor and aroma were the attributes with the lowest acceptance means. The lower mean for flavor compared to other attributes may be related to lemon concentration used in the popsicle formulation. A study evaluating four lemon-flavored yogurt samples found that as lemon concentration increased, acceptance parameters decreased, probably due to acidity and residual lemon taste.¹⁷ Besides answering regarding popsicle acceptance, volunteers made comments when attributes scored below seven, including “could be sweeter,” “bitter at the end,” and “would like more flavor, to be sweeter,” showing that absence of sugars, common in edible ice, may have influenced acceptance.

Another highly significant aspect potentially influencing acceptance test results for aroma and flavor is related to ice cream chemical composition. In commercial popsicle formulations, different ingredients are used such as fat in emulsion form, protein, stabilizers, insoluble sugars (colloidal suspension), lactose, and salts; sugar is an essential ingredient exerting strong influence over flavor.¹⁸ Popsicle consumers associate it with a sweet flavor, and the absence of this attribute may have influenced evaluation scores. A future alternative could be to evaluate changes in quantities of sweeteners and sugars used in the popsicle’s base formula.

In sensory analysis with patients, utilizing the acceptance test (Table 4), flavor was also the attribute with the lowest score, and some assessors noted a bitter taste. Among the 118 patients in this study, 29 refused parts of the popsicle. Within the pharmaceutical industry, a study concluded that combining the sweeteners fructose and saccharin was an effective tool for improving the taste of excessively bitter drugs.¹⁹ In the case of the product evaluated here, which is an innovation akin to a commercial popsicle, individuals generally associate popsicles with sweet sensations. The same study proposes the development of pediatric medicines and regards the concept of palatability as essential for acceptance of medication by pediatric patients.¹⁹ One alternative was using formulations known as medicinal chocolates, which are more appealing to pediatric publics without compromising medication composition.²⁰

Considering palatability, a concept that strongly influences acceptance and adherence to pediatric treatments is essential and serves as an example for the menthol popsicle formulation. However, the addition of sugars via sweeteners and flavorings is not simple, since it can alter the chemical and structural composition of products.²¹ Therefore, it would be advisable to propose a reanalysis of the formula’s composition, and the quantities of sweeteners and flavorings present in the popsicle to improve flavor acceptance.²²

The acceptance test results (Table 2) did not identify a popsicle that was more accepted to be tested by the final consumer (surgical patient). Consequently, the popsicle sample with the highest acceptability index in the “flavor” attribute (Popsicle A - 55%) was selected to proceed with testing in patients.

Results shown in Table 4 refer to the acceptance test conducted with surgical patients and demonstrated that global acceptance of the popsicle yielded a mean considered satisfactory, since results between five and seven on the scale indicate the product acceptance range. This result may have influenced acceptance by patients, and the context of fasting, thus having greater thirst than volunteers, may also have influenced results.

Differences in evaluation of the same product relate to characteristics of the final consumer. In this research, thirst in patients in a real hospitalization setting, fasting and awaiting surgery, influenced the evaluation process. A study that evaluated acceptance of high-protein popsicles for chemotherapy patients conducted sensory tests within the hospital environment, producing more reliable results mainly due to the influence of the environment and the health-disease condition of the patients.²³

Although sensory tests performed in sensory analysis laboratories are considered highly effective, applying the same tests to patients within the hospital setting resulted in differences in outcomes. This fact reflects the importance of conducting research with the final consumer, since patients’ thirst, underscored by fasting in contrast to healthy volunteers, influenced popsicle acceptance.

Differences in acceptance of the same popsicle between volunteers and surgical patients indicate that factors such as thirst combined with surgical procedures and their physical and psychological repercussions may have led to better popsicle acceptance in patients. Therefore, thirst can be considered a determinant factor in tests involving the final consumer, given that patients with fluid intake restrictions, such as surgical patients, report other symptoms when thirsty, such as oral dryness.²⁴ Conversely, common consumers have different expectations regarding flavor when presented with a product denominated as a popsicle.

Other attributes such as color, aroma, and texture also presented means above five in tests with patients (Table 4), demonstrating better acceptance of the menthol and lemon popsicle compared to acceptance means obtained for the same popsicle in tests with volunteers without thirst. A systematic review conducted to identify sensory preferences in supplements for cancer patients found differences, especially regarding taste, showing that cancer patients presented higher acceptance means when compared to acceptance by healthy volunteers.²⁵

A study aimed at understanding physiology of the structures involved in thirst and satiety identified systems considered anticipatory for satiety. In this manner, use of cold temperatures is key to activating preabsorptive satiety. Some pathways involved in this anticipatory process relate to sensory and gustatory perception. Another important mechanism that inhibits brain areas related to thirst is swallowing.⁹

These results support the significant increase in acceptance means for the popsicle by thirsty volunteers, demonstrating that most attributes had satisfactory evaluation, with acceptance indices exceeding 70%. Flavor was the attribute with the lowest acceptance means, both in the evaluation with volunteers (3.85), below four, indicating neutrality within the seven-point scale, and in evaluation with surgical patients (4.75).

Cold strategies with menthol, such as the popsicle, have opened an innovative path in approaching patients with fluid intake restriction who experience thirst and related symptoms. A study in immediate postoperative bariatric surgery patients evaluating a menthol popsicle found that 94% of patients considered the popsicle’s appearance pleasant (66%) or very pleasant (28%). Regarding refreshment, 96% of patients responded that the popsicle was refreshing (44%) or very refreshing (52%). Although this study did not evaluate the same requirements as the present research with acceptance tests, the results reinforce the importance of cold strategies to reduce thirst intensity and discomfort in the immediate postoperative period. In this sense, the higher acceptance means of the popsicle when tested with patients prior to surgery are justified because of the fundamental function of the popsicle: quenching thirst.²⁴ Other issues such as humanized care and attention given to patients experiencing thirst should also be considered.⁸ Other issues such as humanized care and attention given to patients experiencing thirst should also be considered.8 Other studies involving popsicles designed for cancer patients showed satisfactory results both in reducing thirst intensity and in relieving dry mouth symptoms. Furthermore, patient satisfaction increased because they felt valued simply by someone contributing to their nourishment.²³

 Performing affective tests with the final consumer was crucial to considering the main characteristics of the popsicle, including the acceptance of its flavor. Tests carried out with the final consumer and under conditions in which the product will be consumed obtain more realistic results regarding consumer acceptance.²⁶

Even in the presence of sensory tests, a study limitation was not evaluating thirst intensity in surgical patients and healthy volunteers before and after popsicle ingestion.

The main contributions of this research are related to popsicle evaluation by patients and, above all, the possibility of offering the popsicle as a strategy for thirst relief, contributing to clinical practice and promoting more humanized care.

Conclusion

Sensory acceptance tests showed similar behavior both among healthy volunteers and among preoperative surgical patients, demonstrating the importance of both populations in developing a product strategy for patients in pre- and postoperative periods. However, these populations differed regarding score values. Surgical patients presented higher scores both in global acceptance and in attributes (color, aroma, flavor, and texture). Given that flavor was the attribute receiving the lowest mean ratings by healthy volunteers and preoperative patients, improvements in this attribute must be sought to increase overall acceptance of the studied product. 

Author contributions

Study conception: Carla Brandão de Oliveira, Ligia Fahl Fonseca. Data collection: Carla Brandão de Oliveira, Leonel Alves do Nascimento, Ligia Fahl Fonseca. Data analysis and interpretation: Carla Brandão de Oliveira, Leonel Alves do Nascimento, Marília Ferrari Conchon, Paulo de Tarso Carvalho, Ligia Fahl Fonseca. Manuscript writing: Aline Korki Arrabal Garcia Massardi, Carla Brandão de Oliveira, Marília Ferrari Conchon, Paulo de Tarso Carvalho, Ligia Fahl Fonseca. Critical manuscript review: Aline Korki Arrabal Garcia Massardi, Carla Brandão de Oliveira, Leonel Alves do Nascimento, Marília Ferrari Conchon, Paulo de Tarso Carvalho, Ligia Fahl Fonseca. Final text version approval: Aline Korki Arrabal Garcia Massardi, Carla Brandão de Oliveira, Leonel Alves do Nascimento, Marília Ferrari Conchon, Paulo de Tarso Carvalho, Ligia Fahl Fonseca. 

Conflict of interest

The authors declare no conflict of interest. 

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Corresponding Author

Name: Carla Brandão de Oliveira

E-mail: carla.brandao.oliveira@uel.br

© The Author(s) 2025. This work is licensed under Creative Commons Attribution 4.0 International. License text for use: https://creativecommons.org/licenses/by/4.0/