Nice summary of a topic that’s still evolving but definitely highly relevant for clinical practice. The indications for GLP1 agonists seem to be increasing by the day. I do feel, however, gastric ultrasound deserves a mention here. What are your thoughts on if it fits in the preoperative workflow?
Gastric ultrasound is probably the only effective way to risk stratify these patients on the day of surgery if they're following regular fasting guidelines. If imaging shows an empty stomach then you probably have no increased risk of aspiration.
Right now, I think it would be an ineffective widespread recommendation because most practices and providers are probably not able to perform it. Since 2024 it is being tested on the US oral boards, so I imagine there will be widespread adoption within the next 10 years. That could be practice changing across many situations (any urgent/emergent case), not just GLP-1 RA use.
Nice summary of a topic that’s still evolving but definitely highly relevant for clinical practice. The indications for GLP1 agonists seem to be increasing by the day. I do feel, however, gastric ultrasound deserves a mention here. What are your thoughts on if it fits in the preoperative workflow?
Gastric ultrasound is probably the only effective way to risk stratify these patients on the day of surgery if they're following regular fasting guidelines. If imaging shows an empty stomach then you probably have no increased risk of aspiration.
Right now, I think it would be an ineffective widespread recommendation because most practices and providers are probably not able to perform it. Since 2024 it is being tested on the US oral boards, so I imagine there will be widespread adoption within the next 10 years. That could be practice changing across many situations (any urgent/emergent case), not just GLP-1 RA use.