Influence of semaglutide use on the presence of residual gastric solids on gastric ultrasound: a prospective observational study in volunteers without obesity recently started on semaglutide
Open accessAbstract
Purpose Glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1RAs) have become increasingly popular as both diabetic and weight loss therapies. One effect of this class of medication is delayed gastric emptying, which may impact the risk of aspiration during anesthesia delivery. Methods In this prospective study, we used gastric ultrasound to evaluate the presence of solid gastric contents in both supine and lateral positions after an eight-hour fast in those taking GLP-1RA compared with controls. Participants underwent a second ultrasound evaluation two hours later after drinking 12 fluid ounces of water (approximately 350 mL). Results Twenty adults voluntarily enrolled, giving a total of ten participants in each group. In the supine position, 70% of semaglutide participants and 10% of control participants had solids present on gastric ultrasound (risk ratio [RR], 3.50; 95% confidence interval [CI], 1.26 to 9.65; P = 0.02.) In the lateral position, 90% of semaglutide participants and 20% of control participants had solids identified on gastric ultrasound (RR, 7.36; 95% CI, 1.13 to 47.7; P = 0.005). Two hours after drinking clear liquids, the two groups did not differ in the lateral position, but in the supine position, 90% of control group participants were rated as empty compared with only 30% of semaglutide group participants (P = 0.02). Conclusions This study provides preliminary evidence that GLP-1RAs may affect gastric emptying and residual gastric contents following an overnight fast and two hours after clear liquids, which may have implications for aspiration risk during anesthetic care.
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In a prospective study of individuals initiated on semaglutide evaluated by ultrasound after an overnight fast, 70% of those receiving semaglutide exhibited retained solid gastric content, compared with 10% in the control group.
“A prospective study involving individuals initiated on semaglutide, evaluated via ultrasound after an overnight fast, demonstrated that 70% of those receiving semaglutide exhibited retained solid gastric content, in contrast to 10% in the control group [17].”
From Exploring the Side Effects of GLP-1 Receptor Agonist: To Ensure Its Optimal Positioning (2025) · cites this paper as [17]
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- Authors
- Sherwin, M., Hamburger, J., Katz, D., & DeMaria, S.
- Affiliations
- Icahn School of Medicine at Mount Sinai (US)
- Corresponding author
- DeMaria, Samuel
- Venue
- Canadian Journal of Anesthesia/Journal canadien d'anesthésie
- Published
- 2023-07-19
- Volume
- 70
- Issue
- 8
- Pages
- 1300-1306
- ISSN
- 0832-610X (ISSN-L)
- 1496-8975
- OpenAlex
- W4384663033
- Cited by
- 132
- References
- 29
- Citations by year
- 2026: 27 · 2025: 45 · 2024: 53 · 2023: 7
- FWCI
- 24.76
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Canadian Journal of Anesthesia/Journal canadien d anesthésie (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Airway Management and Intubation Techniques
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Keywords
- semaglutide, GLP-1 receptor agonists, gastric emptying, gastric ultrasound, aspiration risk, anesthesia, weight loss treatment
- MeSH terms
- Glucagon-Like Peptide-1 Receptor, Glucagon-Like Peptide-1 Receptor Agonists, Semaglutide, Adult, Diabetes Mellitus, Type 2, Humans, Hypoglycemic Agents, Obesity, Prospective Studies, Volunteers
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