Point-of-care gastric ultrasound assessment guiding safe anesthesia in a patient on prolonged oral semaglutide use
case report
DOI:
https://doi.org/10.63162/v66n68e25625Keywords:
Glucagon-like peptide-1 receptor agonists, Ultrasonography, Gastric emptying, Respiratory aspiration, AnesthesiaAbstract
Glucagon-Like Peptide-1 Receptor Agonists (GLP-1 RAs), such as semaglutide, delay gastric emptying and may increase the risk of pulmonary aspiration during general anesthesia. We report the application of point-of-care gastric ultrasound (POCUS-G) to stratify this risk in a chronic user of oral semaglutide. Case report: A 40-year-old woman, ASA II, with persistent post-gestational diabetes mellitus, on oral semaglutide 7 mg/day for 12 months (discontinuation advised 15 days prior to surgery). A 12-hour fasting period was confirmed. POCUS-G revealed an antral cross-sectional area of 5.81 cm² in the supine position and 4.94 cm² in the right lateral decubitus position; estimated gastric volume was 49 mL (0.72 mL/kg), below the high-risk threshold of 1.5 mL/kg. General anesthesia with a modified rapid sequence induction was performed uneventfully. POCUS-G enabled safe anesthetic management and avoided surgical cancellation. This technique supports individualized decision-making in patients using GLP-1 RAs.
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