ABHISHEK KUMAR BARNWAL, ARCHANA GAUTAM, Veena Bharti, SARVESH KUMAR PATHAK
Objective: The primary objective was to estimate actual fasting durations for solid foods and clear fluids. Secondary objectives included assessing preoperative thirst using the Perioperative Thirst Discomfort Questionnaire, recording the incidence of postoperative nausea and vomiting (PONV), measuring patient satisfaction, and evaluating the safety of the 'Sip Till Send' (STS) hydration protocol. Methods: A controlled trial using the Plan-Do-Study-Act (PDSA) model was conducted over six months at Maharshi Vashishtha Autonomous State Medical College, Basti, Uttar Pradesh. Adults (18–65 y) scheduled for elective surgery under general anaesthesia were included, excluding emergencies and high-risk cases. A total of 1350 elective surgical patients were included in the study. The intervention group received the 'Sip Till Send' (STS) protocol, allowing sips of fluids until operating room transfer; the control group followed standard fasting. Outcomes included fasting duration, thirst scores, patient satisfaction, postoperative nausea and vomiting (PONV), and safety. Data were analysed using SPSS (p<0.05). Results: A total of 1,350 patients participated (STS: n=772; control: n=578). The STS group demonstrated a significant reduction in median fluid fasting time (3.5±1.0 h vs. 7.5±1.5 h, p<0.001). Perioperative thirst discomfort was markedly lower in the STS group (mean score 3.1±2.4 vs. 7.1±2.9, p<0.001).98% patients of the STS group and 60% in the control groupdid not complain of nausea and vomiting in the postoperative period. Patient satisfaction scores improved correspondingly. No pulmonary aspiration events were reported, confirming the safety of the protocol. Iterative PDSA cycles improved adherence and clinical outcomes. Conclusion: The 'Sip till Send' protocol effectively reduces preoperative fluid fasting duration, alleviates patient thirst, and enhances satisfaction without compromising safety. These findings support wider implementation of STS as a perioperative hydration strategy to improve patient comfort and outcomes.