• Leonardo Barbosa Santos, Glenio B Mizubuti, da SilvaLeopoldo MunizLMDepartment of Anesthesiology - São Luiz Hospital - Itaim/Rede D'Or - CMA Anesthesia Team, São Paulo, Brazil; Rede D'Or, D'Or Institute for Research and Education (IDOR), São Paulo, Brazil. Electronic address: leopoldo_muniz@hotmail, Saullo Queiroz Silveira, Rafael Souza Fava Nersessian, AbibArthur de Campos VieiraACVDepartment of Anesthesiology - São Luiz Hospital - Itaim/Rede D'Or - CMA Anesthesia Team, São Paulo, Brazil. Electronic address: arthur.abib@saoluiz.com.br., Fernando Nardy Bellicieri, LimaHelidea de OliveiraHORede D'Or, D'Or Institute for Research and Education (IDOR), São Paulo, Brazil. Electronic address: helidea.lima@rededor.com.br., Anthony M-H Ho, Gabriel Silva Dos Anjos, de MouraDiogo Turiani HourneauxDTHDepartment of Endoscopy - Vila Nova Star Hospital/Rede D'Or - CMA Anesthesia Team, São Paulo, Brazil. Electronic address: dthmoura@hotmail.com., Eduardo Guimarães Hourneuax de Moura, and Joaquim Edson Vieira.
• Department of Anesthesiology - São Luiz Hospital - Itaim/Rede D'Or - CMA Anesthesia Team, São Paulo, Brazil; Rede D'Or, D'Or Institute for Research and Education (IDOR), São Paulo, Brazil. Electronic address: bs.leonardo@icloud.com.
• J Clin Anesth. 2024 Oct 29; 99: 111668111668.

BackgroundRecent evidence suggests that perioperative semaglutide use is associated with increased residual gastric content (RGC) and risk of bronchoaspiration under anesthesia. We compared the occurrence of increased RGC in semaglutide users and non-users undergoing esophagogastroduodenoscopy to define the time interval at which RGC becomes comparable between groups.MethodsThis was a single-center retrospective electronic chart review at a tertiary hospital. Patients undergoing esophagogastroduodenoscopy under deep sedation/general anesthesia between July/2021-July/2023 were included and divided into two (SG = semaglutide, NSG = non-semaglutide) groups, according to whether they had received semaglutide within 30 days prior to the esophagogastroduodenoscopy. Univariate and multivariate logistic regression were performed to explore which factors were associated with increased RGC, defined as any amount of solid content, or > 0.8 mL/Kg (measured from the aspiration/suction canister) of fluid content.ResultsAmong the 1094 (SG = 123; NSG = 971) patients included, increased RGC was observed in 56 (5.12%), being 25 (20.33%) in the SG and 31 (3.19%) in the NSG (p < 0.001). Following weighted analysis, the presence of ongoing digestive symptoms (nausea/vomiting, dyspepsia, and/or bloating/abdominal distension) pre-esophagogastroduodenoscopy [OR = 15.1 (95% confidence interval (CI) 9.85-23.45)] and the time intervals of preoperative semaglutide interruption < 8 days [OR 10.0 (95%CI 6.67-15.65)] and 8-14 days [4.59 (95%CI 2.91-7.37)] remained significantly associated with increased RGC. Following inverse probability treatment weighting adjustment including a composite variable 'time intervals of semaglutide interruption' versus 'presence of ongoing digestive symptoms', only time intervals > 14 days and without digestive symptoms showed no association with increased RGC [OR = 0.77 (95%CI 0.22-2.01)].ConclusionsPerioperative semaglutide use is associated with increased RGC in patients undergoing elective esophagogastroduodenoscopy. Preoperative discontinuation of > 21 days and > 14 days in patients with and without ongoing digestive symptoms, respectively, resulted in RGC similar to non-semaglutide users.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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