Patients on GLP-1 Agents May Need to Have Longer NPO Times Prior to Sedation

Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly prescribed for patients with type 2 diabetes and for weight loss. They may delay gastric emptying, thus making patients at risk for regurgitation and perhaps aspiration when protective reflexes are blunted during deep sedation and general anesthesia. Objective: To assess residual gastric content (RGC) in patients who have not consumed food or drink (NPO) prior to general anesthesia. Design: Prospective single-center trial. Participants: 124 patients (median age, 56 years) taking a weekly GLP-1RA. Methods: Patients undergoing general anesthesia who had been NPO underwent preinduction gastric ultrasounds to measure stomach contents. They were then categorized based on whether they had taken an injectable GLP-1 inhibitor in the last week, and further analysis was performed to determine the timing of their last dose. Fasting was defined as 2 hours for clear liquids, 6 hours for a light meal, and 8 hours for more...