Preop Gastric Ultrasound Reveals Persistent Full Stomach Risk in GLP-1 Therapy Patients

Background: The expanding use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) has introduced new perioperative concerns, particularly due to their effect on delaying gastric emptying. Despite adherence to traditional fasting guidelines, patients receiving these medications may still harbor significant residual gastric contents (RGCs), raising the possibility of aspiration during anesthesia. Objective: To determine which preoperative factors are associated with increased RGCs in adults taking GLP-1RAs undergoing anesthesia. Design: Retrospective, multicenter observational study. Methods: 316 adult patients on GLP-1RAs who underwent anesthesia across 3 hospitals between June 30, 2023, and August 15, 2024, were included. All participants received point-of-care gastric ultrasonography (GUS) immediately prior to their procedures. GUS was used to assess both the volume and nature of gastric contents. High RGC was defined as presence of solid material or clear fluids exceeding 1.5 m more...