Abstract
Background
Elderly patients with hip fractures are often malnourished and in a catabolic state upon admission to hospital. Waiting time for surgery is commonly unpredictable, and often more than 24 hours. Due to an assumed stress-induced delayed gastric emptying time with a possible associated risk of aspiration, fasting guidelines are the same as for other trauma patients. This leads to prolonged fasting time in these patients who are often metabolically compromised, with negative effects on post-operative recovery and prolonged hospital stay. The aim of this study was to investigate if 400 ml of a carbohydrate-rich beverage could be given to patients with a hip fracture 2–3 hours before surgery without carrying a risk of pulmonary aspiration.
Methods
The gastric emptying rate of 400 ml 12.6 % carbohydrate rich drink was investigated in ten elderly women with a hip fracture awaiting surgery. The emptying rate was assessed by an indirect method, the paracetamol absorption technique. Results were compared with two control groups of healthy persons.
Results
In the hip fracture patients, the mean gastric half-emptying time was 57 ± 5 minutes and displayed a normal emptying profile. The corresponding result in the control group was 58 ± 5 minutes. One hip fracture patient was excluded due to vomiting before finishing intake, i.e. before the anaesthesia procedure.
Conclusions
In this pilot study, gastric emptying in nine elderly women with a hip fracture was not delayed. We suggest that it should be possible to give a carbohydrate-rich beverage 2–3 hours before surgery to most hip fracture patients. Patient selection is an issue.
