Preoperative fasting guidelines are a necessary component of surgical preparation of the patient. The American Society of Anesthesiologists (ASA) have conventionally recommended a period of fasting of 6 hours for light meals and 2 hours for clear liquids for adults undergoing elective surgeries. Adequate fasting periods are required to prevent adverse intra operative complications like pulmonary aspiration of gastric contents. In recent times, adaptability to the said fasting periods have been proposed with an aim to reduce prolonged fasting. Long hours of fasting preoperatively can lead to dehydration, patient discomfort and increased catabolic response to surgery. A modular update of The Practice guidelines for preoperative fasting periods were introduced by the ASA in 2017 that focused on reducing unnecessary prolonged fasting periods along with the use of pre surgery carbohydrate drinks.  

Additionally, post spinal induction hemodynamic instability intraoperatively has been known to occur significantly more in the elderly age group. The incidence of spinal induced hypotension increases up till 75% in age group over 5o years of age as opposed to 36% incidence in younger age groups.

Therefore, with the use of of pre-surgical carbohydrate loading as per the Modular ASA guidelines, we aim to evaluate the incidence of and measure intraoperative hypotension occurring in elderly age groups consuming pre surgery carbohydrate loading among patients posted for elective Transurethral Resection of Prostate (TURP) under spinal anesthesia and contrast this with another matched cohort following conventional preoperative fasting advice. It will be a Randomized controlled trial, single blinded study.
In conjecture to this we aim to hypothesise the mean duration of preoperative fasting that the latter group of patients follow as per conventional nil per oral fasting guidelines in our institute.