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Case Reports
. 2023 Jul 19;15(7):e42153.
doi: 10.7759/cureus.42153. eCollection 2023 Jul.

Anesthesia Considerations for a Patient on Semaglutide and Delayed Gastric Emptying

Erina Fujino  1 , Kathryn W Cobb  1 , Jay Schoenherr  1 , Lindsey Gouker  1 , Elisa Lund  1
Affiliations
Case Reports

Anesthesia Considerations for a Patient on Semaglutide and Delayed Gastric Emptying

Erina Fujino et al. Cureus. .

Abstract

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.

Keywords: anesthesia; delayed gastric emptying; glp-1; glucagon-like peptide-1 receptor agonist; pulmonary aspiration; semaglutide.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. EGD showing the presence of food in the stomach despite fasting to solids for over 10 hours.
EGD: esophagogastroduodenoscopy
Figure 2
Figure 2. EGD showing no presence of food after adhering to a liquid diet for 36 hours before the repeat procedure.
EGD: esophagogastroduodenoscopy
See this image and copyright information in PMC

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