Hormonal
GLP-1 receptor agonists significantly increase the volume of retained gastric contents in fasting patients, but this does not translate to a statistically significant increase in actual pulmonary aspiration rates.
If you take a GLP-1 drug (like Ozempic or Wegovy) and have surgery, your stomach might stay fuller longer, but you are not significantly more likely to vomit into your lungs than someone who doesn't take it. Do not stop your medication without asking your surgeon or anesthesiologist, as modern guidelines suggest continuing it for most people while using other safety checks like ultrasound.
Recent meta-analyses involving over 300,000 patients report that while the retained gastric contents are significantly increased (fivefold to tenfold increase; odds ratio 3.35–36.97), rates of pulmonary aspiration (0.1% to 0.2%) remain quite low, with no significant increase in comparison to control groups.
Why this rating
Based on meta-analyses of over 300,000 patients and large prospective studies.
Source
Perioperative Management of GLP-1 Receptor Agonists: Balancing Aspiration Risk with Therapeutic Benefit
Enoch Chi Ngai Lim et al. · SN Comprehensive Clinical Medicine · 2025
DOI 10.1007/s42399-025-02079-9
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- Current clinical guidelines recommend continuing GLP-1 receptor agonists for most patients undergoing elective surgery, shifting away from routine preoperative cessation.Strong
- Long-term stable use of GLP-1 receptor agonists results in attenuated gastric emptying effects (tachyphylaxis) compared to recent initiation, reducing perioperative risk.Good
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