Semaglutide use linked to "full stomach" risk in fasting surgical patients, prompting new perioperative guidelines

Delayed gastric emptying, a known effect of GLP-1 receptor agonists like semaglutide, poses a significant risk for pulmonary aspiration during anesthesia. Current fasting guidelines (8 hours for solids, 2 hours for clear liquids) may be insufficient for patients on these medications, potentially leading to a "full stomach" even after prolonged fasting. This creates a critical gap in perioperative safety protocols, necessitating evidence-based recommendations to mitigate aspiration risk in this growing patient population.

This study protocol outlines a comparison of gastric emptying via gastric ultrasound in volunteers using semaglutide versus a control group not on the medication. Participants will undergo standard preoperative fasting protocols, specifically at least 8 hours for solids and 2 hours for clear liquids. The primary endpoint is the prevalence of a "full stomach," defined as a binary outcome based on ultrasound findings. The study aims to correlate this incidence with the time interval since the last semaglutide dose to inform updated perioperative management strategies for these patients.