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Cited by 43Enhanced Recovery After SurgeryDiabetes Treatment and ManagementAnesthesia and Sedative Agents

Effect of various perioperative semaglutide interruption intervals on residual gastric content assessed by esophagogastroduodenoscopy: A retrospective single center observational study

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Santos, Leonardo Barbosa, Mizubuti, Glenio B., da Silva, Leopoldo Muniz, Silveira, Saullo Queiroz, Nersessian, Rafael Souza Fava, Abib, Arthur de Campos Vieira, Bellicieri, Fernando Nardy, Lima, Helidea de Oliveira +5 more·2024·Journal of Clinical Anesthesia
DOI 10.1016/j.jclinane.2024.111668
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Abstract

BACKGROUND: Recent evidence suggests that perioperative semaglutide use is associated with increased residual gastric content (RGC) and risk of bronchoaspiration under anesthesia. We compared the occurrence of increased RGC in semaglutide users and non-users undergoing esophagogastroduodenoscopy to define the time interval at which RGC becomes comparable between groups. METHODS: This was a single-center retrospective electronic chart review at a tertiary hospital. Patients undergoing esophagogastroduodenoscopy under deep sedation/general anesthesia between July/2021-July/2023 were included and divided into two (SG = semaglutide, NSG = non-semaglutide) groups, according to whether they had received semaglutide within 30 days prior to the esophagogastroduodenoscopy. Univariate and multivariate logistic regression were performed to explore which factors were associated with increased RGC, defined as any amount of solid content, or > 0.8 mL/Kg (measured from the aspiration/suction canister) of fluid content. RESULTS: Among the 1094 (SG = 123; NSG = 971) patients included, increased RGC was observed in 56 (5.12%), being 25 (20.33%) in the SG and 31 (3.19%) in the NSG (p < 0.001). Following weighted analysis, the presence of ongoing digestive symptoms (nausea/vomiting, dyspepsia, and/or bloating/abdominal distension) pre-esophagogastroduodenoscopy [OR = 15.1 (95% confidence interval (CI) 9.85-23.45)] and the time intervals of preoperative semaglutide interruption < 8 days [OR 10.0 (95%CI 6.67-15.65)] and 8-14 days [4.59 (95%CI 2.91-7.37)] remained significantly associated with increased RGC. Following inverse probability treatment weighting adjustment including a composite variable 'time intervals of semaglutide interruption' versus 'presence of ongoing digestive symptoms', only time intervals > 14 days and without digestive symptoms showed no association with increased RGC [OR = 0.77 (95%CI 0.22-2.01)]. CONCLUSIONS: Perioperative semaglutide use is associated with increased RGC in patients undergoing elective esophagogastroduodenoscopy. Preoperative discontinuation of > 21 days and > 14 days in patients with and without ongoing digestive symptoms, respectively, resulted in RGC similar to non-semaglutide users.

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Authors
Santos, L. B., Mizubuti, G. B., da Silva, L. M., Silveira, S. Q., Nersessian, R. S. F., Abib, A. D. C. V., Bellicieri, F. N., Lima, H. D. O., Ho, A. M.-H., dos Anjos, G. S., de Moura, D. T. H., de Moura, E. G. H., & Vieira, J. E.
Affiliations
  • D’Or Institute for Research and Education (BR)
  • Queen's University (CA)
  • Universidade de São Paulo (BR)
Corresponding author
Mizubuti, Glenio B.
ORCID
Venue
Journal of Clinical Anesthesia
Publisher
Elsevier BV
Published
2024-12
Volume
99
Pages
111668
ISSN
0952-8180 (ISSN-L)
DOI
10.1016/j.jclinane.2024.111668
OpenAlex
W4403940311
Cited by
43
References
12
Citations by year
2026: 20 · 2025: 20 · 2024: 3
FWCI
18.11
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Clinical Anesthesia (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
Keywords
semaglutide, residual gastric content, upper gastrointestinal endoscopy, bronchial aspiration, time intervals, general anesthesia, deep sedation, gastrointestinal symptoms, nausea and vomiting, dyspepsia, bloating, abdominal distension, GLP-1 receptor agonists, aspiration risk, inverse probability of treatment weighting, causal inference
MeSH terms
Semaglutide, Adult, Aged, Anesthesia, General, Drug Administration Schedule, Glucagon-Like Peptides, Female, Humans, Male, Middle Aged, Retrospective Studies, Time Factors, Endoscopy, Digestive System, Perioperative Care, Deep Sedation, Respiratory Aspiration of Gastric Contents

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