Given the pharmacodynamic and pharmacokinetic properties of glucagon-like peptide-1 (GLP-1) agonists, the Canadian Anesthesiologists' Society has recognized that patients on GLP-1 agonists may have an increased aspiration risk due to a 'full stomach,' even after following preoperative fasting guidelines. In other words, safe fasting timelines are not known in individuals taking GLP-1 agonists, as demonstrated by recent case reports of patients who either retained or regurgitated stomach contents despite being adequately fasted. To address this gap, we plan to measure preoperative residual gastric volumes with point-of-care ultrasound (POCUS) in patients taking this medication. The priority is to first gather data to identify which patient populations need risk stratification and to then use this data to support the development of specific guidelines that reduce anesthetic complications, such as aspiration pneumonia. Our primary objective is to use POCUS preoperatively to assess gastric volumes of fasted patients to demonstrate if there is a clinically significant increase in residual gastric volumes in patients on semaglutide.
Study Type
OBSERVATIONAL
Enrollment
90
Participant will undergo gastric antrum ultrasound and be scanned in the supine position followed by the right lateral decubitus position. Qualitative and quantitative assessments will be completed.
South Health Campus
Calgary, Alberta, Canada
RECRUITINGNumber of participants presenting with a full stomach
Full stomach defined as either clear fluid \> 1.5ml/kg or solid content found with point-of-care gastric antral sonography.
Time frame: Measured in the preoperative holding area
Number of occurrences requiring change in anesthetic management plan
Changes in plan include those from laryngeal mask airway to more advanced endotracheal tube with rapid sequence induction and intubation or spinal anesthetic without sedation to administration of a general anesthetic.
Time frame: From time of preoperative ultrasound in holding area to anesthesia induction in operating room
Relationship between dose, duration and timing of GLP-1 receptor agonist and gastric volume
Explore if dose, duration, and timing of GLP-1 receptor agonist affects gastric volume
Time frame: Measured in the preoperative holding area
Relationship between gastric emptying and purpose of GLP-1 receptor agonist administration
Explore if GLP-1 receptor agonist impacts gastric emptying different in patients administering for Type II diabetes mellitus or weight management
Time frame: Measured in the preoperative holding area
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.