Evaluation of Gastric Content of Volunteers Fasting and Using Semaglutide: an Observational and Cross-sectional Study

INTRODUCTION

Obesity and type 2 diabetes mellitus constitute a global public health problem. Medications with glucagon-like peptide-1(GLP-1) receptor agonist action are a modern therapeutic option for both diseases. Liraglutide, semaglutide and dulaglutide are some representatives of this drug class, whose mechanism of action results in slowing gastric emptying, reduced gastric motility, and increased gastric volume These effects are implicated in both weight loss and the occurrence of adverse events such as nausea, vomiting, acute gastroparesis and gastroesophageal reflux disease (GERD) The presence of gastric contents during the anesthetic procedure can lead to pulmonary aspiration and the development of chemical pneumonitis, a potentially fatal complication. To avoid this risk, in healthy patients, an 8-hour fast for solids and 2 hours for clear liquids. However, when there is a risk factor for slow gastric emptying, despite adequate fasting, the stomach may present residues and bedside ultrasound is an effective, non-invasive and quickly to measure this content and stratify the risk of aspiration Due to the lack of studies demonstrating that the use of GLP-1 analogue can increase the risk of aspiration in individuals who are fasting adequately to receive anesthesia, there is no formal recommendation for performing gastric ultrasound in the preoperative period, nor for the suspension of these medications. Some institutions empirically recommend suspension preoperatively.

Given the severity of the occurrence of bronchoaspiration, the biological action of GLP-1 analogues on gastric function and the incremental use of these medications, it is necessary to better understand the gastric contents of individuals fasting and using a GLP-1 analogue. GLP-1. Thus, through ultrasound, we will aim to evaluate the gastric contents of volunteers who do not have risk factors for bronchoaspiration, who will not undergo anesthesia, but are fasting recommended for this purpose and are using semaglutide, a GLP-1 analogue.

Our hypothesis is that the majority of individuals using these medications have a full stomach even with the fasting times recommended in the literature. In view of this, for this population we must adapt safety criteria during the anesthetic procedure.

Objectives Primary objective The primary objective is to evaluate the prevalence of a full stomach through gastric ultrasound examination in volunteers who use semaglutide and are fasting for at least 8 hours for solids and 2 hours for clear liquids. As a control group, we will use volunteers who do not use semaglutide.