Role of Preoperative Oral Rehydration Solution on Myocardial Ischaemia During Orthopaedic Surgery under Spinal Anaesthesia: A Prospective Randomised Study

Abstract

Main Points• Preoperative oral rehydration solution supplementation significantly reduced the post-spinal ischemic electrocardiographic (ECG) changes compared to conventional overnight fasting in elderly patients undergoing elective lower limb orthopaedic surgery under spinal anaesthesia (SA).• It was coherent with unstable haemodynamics and abnormal perfusion parameters at the same intraoperative time points.• No patient complaint of notable anginal symptoms and the underlying ischaemic ECG changes also reverted within an hour of SA induction.• The threshold fasting duration of >3 hours for oral fluids had an area-under-curve of 0.74 to predict ischaemic ECG changes within 30 minutes of SA induction.

Preoperative fasting and the risk of pulmonary aspiration—a narrative review of historical concepts, physiological effects, and new perspectives

“… 103 Preoperative oral rehydration solution supplementation significantly reduced post-spinal transient ischaemic electrocardiographic changes in older patients. 104 …”