Relationship between residual gastric content and peri-operative semaglutide use assessed by gastric ultrasound: a prospective observational study.
Level 3 - non-randomized controlled study
Prospective non-randomized controlled cohort study
PubMed 39435967 · doi:10.1111/anae.16454
What was done
In a prospective observational study, 220 elective surgical patients adhering to standard fasting guidelines were evaluated: 107 who received pre-operative once-weekly subcutaneous semaglutide within 10 days before surgery, and 113 unexposed controls. All patients underwent pre-operative point-of-care gastric ultrasound on the day of surgery. Increased residual gastric content was defined as any solid content or > 1.5 ml.kg⁻¹ of clear fluids.
What was found
Increased residual gastric content was detected in 43 of 107 patients (40%) in the semaglutide group compared to 3 of 113 patients (3%) in the non-semaglutide group (p < 0.001). In propensity-weighted analysis, semaglutide use (OR 36.97, 95% CI 16.54–99.32), male sex (OR 2.28, 95% CI 1.29–4.06), and age (OR 0.95, 95% CI 0.93–0.98) were independently associated with increased residual gastric content. No pulmonary aspiration events occurred in either group.
Why it matters
Interrupting semaglutide for 10 days or fewer prior to elective surgery is frequently insufficient to clear residual gastric content despite standard fasting intervals, indicating persistent aspiration risk.
Limits
This was a non-randomized observational study subject to potential residual confounding. The sample was underpowered to detect rare clinical endpoints such as pulmonary aspiration (0 events observed). The abstract does not provide details on specific semaglutide doses, indications (diabetes vs. obesity), or exact fasting durations.
Cited by
- supports Patients on semaglutide undergoing general anesthesia have been found to retain food in their stomach despite fasting for 24 hours.