Episode 336: 335. Do GLP-1 Cause Residual Gastric Contents

Episode 336: 335. Do GLP-1 Cause Residual Gastric Contents

Because glucagon-like peptide-1 (GLP-1) receptor agonists can slow gastric emptying, they might confer risk for residual gastric contents — and possibly aspiration!!!! Should we stop the glp-1

Should we stop the glp-1-- Anesthesiologists and gastroenterologists have weighed in on this concern and on QM I say just do whatever the anesthesiologist want because they have the final say!!

Sen S et al. Glucagon-like peptide-1 receptor agonist use and residual gastric content before anesthesia. JAMA Surg 2024 Jun; 159:660.

per American Society of Anesthesiologists [ASA] guidelines; Prior to surgery, patients had fasted at least 2 hours for clear liquids, 6 hours for light meals, and 8 hours for full meals

researchers performed gastric ultrasound just prior to elective surgery in 62 patients who were using weekly injected GLP-1 agonists (semaglutide, dulaglutide, or tirzepatide) and in 62 nonusers (controls).

The prevalence of residual gastric contents was significantly higher in the GLP-1 group than in the control group (56% vs. 19%). After adjustment for confounders, GLP-1 users remained significantly more likely than controls to have residual gastric contents.

Sen S et al. Glucagon-like peptide-1 receptor agonist use and residual gastric content before anesthesia. JAMA Surg 2024 Jun; 159:660.

We still don't know the overall clinical consequences of residual gastric contents in GLP-1 users who undergo elective surgery under anesthesia. For now, clinicians who provide preoperative consultation should try to find out policies of local anesthesiology groups.

Jaksot(385)

Episode 423: 430. Hormone Replacement Therapy and the Black Box Warning

Episode 423: 430. Hormone Replacement Therapy and the Black Box Warning

Let’s rewind to the early 2000s. Flip phones were cool, low-rise jeans were a crime, and the Women’s Health Initiative—WHI—dropped what became the medical equivalent of a headline: “Hormone Therapy In...

24 Maalis 12min

Episode 422: 429. Rivaroxaban vs Apixaban = The Battle of the Blood Thinners!

Episode 422: 429. Rivaroxaban vs Apixaban = The Battle of the Blood Thinners!

— rivaroxaban versus apixaban.Yes, folks, this is The Battle of the Blood Thinners!And spoiler alert — one of them came out looking like the overachiever in a safety class... while the other probably ...

20 Maalis 9min

Episode 421: 428. Asthma and Stroke --- A breathless combination

Episode 421: 428. Asthma and Stroke --- A breathless combination

Minocycline in Acute Ischemic Stroke (EMPHASIS trial)A multicenter, double-blind RCT in China studied 1,724 patients with acute ischemic stroke treated within 72 hours of onset. Patients received eith...

13 Maalis 16min

Episode 420: 427. Kawasaki disease-no, not the motorcycle company

Episode 420: 427. Kawasaki disease-no, not the motorcycle company

Today, we're talking about Kawasaki disease-no, not the motorcycle company, though sometimes treating it does feel like trying to ride one at full speed through uncertainty.For decades, high-dose aspi...

11 Maalis 7min

Episode 419: 426. Go Big or Go Partial? The Knee Replacement Showdown

Episode 419: 426. Go Big or Go Partial? The Knee Replacement Showdown

Setting the stagePicture this: your knee is like a three-room apartment. You've got a medial room, a lateral room, and a patellofemoral room. In isolated anteromedial osteoarthritis, just one room is ...

10 Maalis 11min

Episode 418: 425. Triptan initiation and cerebrovascular events

Episode 418: 425. Triptan initiation and cerebrovascular events

Kalapura C, et al. Triptan initiation and cerebrovascular events in patients with migraine: A nationwide cohort study. J Am Heart Assoc 2026 Feb 17; 15:e043409. DOI: 10.1161/JAHA.125.043409.  Today, w...

6 Maalis 6min

Episode 417: 424. GLP1 and NAION

Episode 417: 424. GLP1 and NAION

Li H-Y, et al. GLP-1 receptor agonists and risk of optic nerve or vision-threatening events in patients with type 2 diabetes or cardiometabolic diseases: A meta-analysis of randomized controlled trial...

5 Maalis 8min

Episode 416: 423. CME-- Discharge Questions Answered in 2025

Episode 416: 423. CME-- Discharge Questions Answered in 2025

CME-- Discharge Questions Answered in 2025

3 Maalis 45min

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