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Use of glucagon-like peptide-1 (GLP-1)–receptor agonists prior to procedures that involve sedation or general anesthesia has become a controversial topic. The concern is that GLP-1 agonists, which delay gastric emptying, might be associated with risk for periprocedural pulmonary aspiration.
Several recent studies have documented an association between GLP-1 agonist use and retained gastric contents, demonstrated by direct visualization at endoscopy or by point-of-care ultrasound just before elective surgery (NEJM JW Gen Med Oct 15 2023 and J Diabetes Investig 2023; 14:767; NEJM JW Gen Med Aug 1 2024 and JAMA Surg 2024; 159:660). Nevertheless, GLP-1 agonist users who underwent endoscopy were not at excess risk for pulmonary aspiration in two …