Perioperative GLP-1 Receptor Agonists

CA-1 · I.B.1.d.6 II.C.4.b.3.c II.D.2.e

25Sources
6Kept
0Dropped

1 · Find evidence

PubMed query

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25 candidate papers

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Same-day build

PubMed query

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2 · Teaching points

Source

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6 points

The 2025 multi-society recommendation is to continue GLP-1 receptor agonists perioperatively and instead use a 24-hour clear fluid diet followed by standard 6-hour fasting, with gastric ultrasound if that diet was not completed. PMID 40814081 kept
Pooling 185,414 patients, GLP-1 receptor agonist exposure was not associated with pulmonary aspiration, but across 165,522 patients it raised the odds of residual gastric contents roughly six-fold despite appropriate fasting. PMID 40230298 kept
Before elective endoscopy, semaglutide raised increased residual gastric content from 5.1% to 24.2%, and preoperative digestive symptoms were themselves predictive — but the interruption interval made no difference. PMID 36870274 kept
Ongoing treatment attenuates the delay in gastric emptying, so after more than 12 weeks of therapy standard fasting times are likely sufficient for otherwise low-risk patients; caution belongs with recent starters. PMID 38290907 kept
The AGA rapid clinical practice update provides expert advice on managing patients taking GLP-1 receptor agonists before endoscopy, drawn from recent studies and the authors' bariatric and endoscopic experience. PMID 37944573 kept
After discontinuing GLP-1 receptor agonists, expect a significant weight regain, averaging 5.63 kg in obese patients (95% CI: 3.52-7.73). PMID 41399474 kept

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