One hundred twenty-six patients aged over sixty were randomized to receive preoperative oral rehydration solution (ORS; n=63) or to undergo conventional overnight fasting (n=63). The primary outcome of interest was the occurrence of transient myocardial electrocardiographic ischemic changes within 30 minutes post-spinal anesthesia induction. Secondary outcomes included hemodynamic parameters and intraoperative complications such as hypotension and tachycardia, assessed up to 30 minutes post-induction. Overall, the results of the study revealed that the ORS group had significantly fewer ischemic changes and better hemodynamic stability compared to the fasting group. These findings suggest that preoperative ORS can potentially reduce perioperative myocardial ischemia and improve intraoperative hemodynamic stability in elderly patients undergoing orthopedic surgeries under spinal anesthesia.