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Canadian Journal of Anesthesia/Journal canadien d'anesthésie

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06-06-2023 | Aspiration | Case Reports / Case Series

Regurgitation under anesthesia in a fasted patient prescribed semaglutide for weight loss: a case report

Authors: Michael A. Gulak, MD, Patricia Murphy, MD, FRCPC

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 8/2023

Abstract

Purpose

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) such as semaglutide are a class of medications prescribed to treat type 2 diabetes mellitus, and more recently, as an adjunct for weight loss because of its effects of delaying gastric emptying and suppressing appetite. Semaglutide is a long-acting agent with a half-life of approximately one week, and there are currently no guidelines that address the perioperative management of such agents.

Clinical features

We describe an unexpected case of regurgitation of a large volume of gastric contents upon induction of general anesthesia in a nondiabetic, nonobese patient despite a long preoperative fasting period (20 hr for solids and eight hours for clear fluids). This patient had no traditional risk factors for regurgitation or aspiration but was taking the GLP-1 RA semaglutide for weight loss and had last taken the medication two days before their scheduled procedure.

Conclusions

Patients taking long-acting GLP-1 RAs such as semaglutide may be at risk of pulmonary aspiration under anesthesia. We propose strategies to mitigate this risk including holding the medication four weeks prior to a scheduled procedure when feasible and considering full stomach precautions.

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Title: Regurgitation under anesthesia in a fasted patient prescribed semaglutide for weight loss: a case report
Authors: Michael A. Gulak, MD
Patricia Murphy, MD, FRCPC
Publication date: 06-06-2023
Publisher: Springer International Publishing
Keywords: Aspiration
Foreign Body Aspiration
Foreign Body Aspiration
General Anesthesia
Semaglutide
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 8/2023
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI: https://doi.org/10.1007/s12630-023-02521-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Regurgitation under anesthesia in a fasted patient prescribed semaglutide for weight loss: a case report

Abstract

Purpose

Clinical features

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Clinical features

Conclusions

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