Hormonal
GLP-1 receptor agonists delay gastric emptying via peripheral and central nervous system pathways, creating a significant risk of retained gastric contents and pulmonary aspiration during anesthesia even when standard preoperative fasting guidelines are followed.
If you take a GLP-1 medication (like Ozempic, Wegovy, or Mounjaro) and are scheduled for surgery, you must inform your anesthesiologist and endocrinologist. Do not assume standard fasting rules apply. Your stomach may still contain food, increasing the risk of serious lung complications during anesthesia. Your care team may need to adjust your fasting instructions, postpone elective surgery, or use special techniques to protect your airway.
GLP-1 RAs delay gastric emptying by inhibiting gastrointestinal motility through both PNS and CNS... Because patients treated with GLP-1 RAs are more likely to retain gastric contents (RGC), the risk of aspiration may persist even when standard preoperative fasting guidelines are followed.
Why this rating
The paper is a review citing observational studies, case reports, and conflicting cohort data; it explicitly notes evidence is 'limited and sometimes inconsistent' with 'very low' certainty in meta-analyses.
Source
Delayed gastric emptying induced by glucagon-like peptide-1 receptor agonists and its implications for perioperative risk during anesthesia
Donghee Kang et al. · The Korean Journal of Internal Medicine · 2026
DOI 10.3904/kjim.2025.277
More from this paper
- Current clinical guidelines recommend individualized perioperative management for GLP-1 RA users, with recent consensus shifting from mandatory discontinuation to risk-based assessment based on gastrointestinal symptoms and treatment duration.Good
- Short-acting GLP-1 RAs cause more pronounced delays in gastric emptying than long-acting agents, although long-acting agents may still pose aspiration risks due to residual effects depending on dose and treatment duration.Moderate
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