Anesthesia Considerations for a Patient on Semaglutide and Delayed Gastric Emptying

Aug 21, 2023Cureus

Anesthesia Planning for Patients Taking Semaglutide with Slow Stomach Emptying

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Abstract

A 31-year-old female patient taking semaglutide experienced food residue in the stomach during a preoperative evaluation for bariatric surgery.

Semaglutide is associated with delayed gastric emptying.
Preoperative fasting guidelines for patients on semaglutide are currently lacking.
Food residue in the stomach can increase the risk of pulmonary aspiration during general anesthesia.
Anesthesiologists may need to consider alternative methods to ensure an empty stomach for patients on semaglutide.

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Semaglutide is a class of long-acting glucagon-like peptide-1 receptor agonists (GLP1-RA) used for the treatment of type 2 diabetes mellitus (T2DM) and obesity. We present a 31-year-old female patient with a past medical history of T2DM without complication and no long-term or current use of insulin, class 3 obesity, hypertension, hyperlipidemia, polycystic ovary syndrome (PCOS), and anxiety, who underwent an esophagogastroduodenoscopy (EGD) in preparation for bariatric surgery while taking semaglutide. Despite appropriately following the preoperative fasting guidelines of the American Society of Anesthesiologists (ASA), endoscopy revealed food residue in the gastric body, necessitating abortion of the procedure to reduce the risk of intraoperative pulmonary aspiration. Given the lack of preoperative fasting guidelines for patients on semaglutide to date, and delayed gastric emptying being a known side effect among patients taking semaglutide, anesthesiologists should be aware of alternative methods to ensure no food is present in the stomach to mitigate the risk of pulmonary aspiration during general anesthesia.

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Anesthesia Considerations for a Patient on Semaglutide and Delayed Gastric Emptying

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