Perioperative Considerations for Patients on Semaglutide

This article provides an update on the perioperative considerations for patients on semaglutide, a glucagon-like peptide-1 receptor agonist with rapidly increasing use in the USA.

Since semaglutide may cause delayed gastric emptying and residual gastric contents, controversies arise on preoperative medication management, adequate preoperative fasting periods, utilization of gastric ultrasound, and rapid sequence induction and intubation to mitigate the risks of regurgitation and pulmonary aspiration of gastric contents during anesthesia care.

While semaglutide may cause gastrointestinal symptoms, it has significant beneficial metabolic and cardiovascular effects. Recent consensus-based guidance on preoperative medication instructions, current fasting guidelines, thorough patient history and physical examination, and point-of-care gastric ultrasound can all provide information that facilitates decision-making in the perioperative anesthetic management for patients on semaglutide, ensuring patient safety and positive outcomes.