Authors (including presenting author) :
Leung LM(1), Chiu TC(1), Chan CM(1), Chu KK(1), Hsu YC(1), Chan OK(2), Kong CY(1), Wong CK(1)
Affiliation :
(1)Department of Orthopaedics and Traumatology, United Christian Hospital (2)Department of Anaesthesiology, Pain Medicine and Operating Services, United Christian Hospital
Keyword 4: :
hip fracture
Introduction :
Prolonged fasting before surgery can exacerbate dehydration and discomfort while increasing anxiety and agitation, negatively affecting the patient's well-being. Since August 2024, the UCH O&T department has implemented the “Sip Til Send” program for patients with hip fractures. Target patients are allowed to sip water until they are sent to the operating theatre, aiming to promote patient comfort without increasing the risk of aspiration.
Objectives :
The program aims to avoid prolonged fasting, which can increase the risk of post-operative complications; to promote comfort by alleviating thirst and the discomfort associated with fasting; to reduce anxiety and agitation that may worsen the surgical experience; and to enhance patient satisfaction through more humane and personalized care practices.
Methodology :
Anesthesiologists, orthopedic surgeons, and fracture liaison nurses collaborated to provide pre-operative assessments for all patients with hip fractures aged 60 years or older to determine their suitability for the “Sip Til Send” program. Patient satisfaction was measured by asking patients to rate the statement “Drinking water before surgery makes me feel comfortable” on a five-point Likert scale (1: strongly disagree; 2: disagree; 3: neutral; 4: agree; 5: strongly agree). Any incidents of desaturation associated with “Sip Til Send” were documented.
Result & Outcome :
In 2025, 638 patients were admitted to UCH with hip fractures requiring surgery. Their ages ranged from 60 to 102 years. After assessment, 109 patients participated in the “Sip Til Send” program, resulting in a participation rate of 17.1%. The average age was 80.4 years, the average AMT score was 7.50, and the ratio of elective to emergency surgeries was 42:67. The largest proportion had an ASA score of 3 (66.97%), followed by ASA score 2 (30.28%); ASA score 4 was the least common (1.83%). Spinal anesthesia (SA) was the most common anesthesia method (78.9%) among these patients. 40 patients participated in a telephone follow-up, and the average satisfaction rating for the “Sip Til Send” program was 4.25 out of 5, indicating a reduction in peri-operative discomfort. There were no reports of desaturation associated with the program. In addition, all nursing staff expressed support for the program because it reduced patient anxiety and agitation while waiting for surgery. Although patients with hip fractures tend to be older and have comorbidities, comprehensive assessments can identify a subset of vulnerable patients who may benefit from sipping water prior to surgery.
