Análogos do GLP-1 e risco de broncoaspiração perioperatória: retardo do esvaziamento gástrico e tempo de suspensão pré-operatória: uma revisão integrativa

Vitor  Bastos Mesquita; Gabriela  Bastos Mesquita; Matheus  Cotian Cunha de Lima; Tiago  Guedes Álvares; Sofia  de Souza Barbosa Carneiro; Paulo Henrique  de Aquino Junior

doi:10.63162/v69n73e26727

Authors

Vitor Bastos Mesquita Graduando em Medicina na Universidade Federal de Goiás, Goiânia/GO, Brasil Autor https://orcid.org/0009-0008-6093-0804
Gabriela Bastos Mesquita Graduanda da Pontifícia Universidade Católica de Goiás, Goiânia/GO, Brasil. Autor https://orcid.org/0009-0004-3332-5407
Matheus Cotian Cunha de Lima Graduando em Medicina na Universidade Federal de Goiás, Goiânia/GO, Brasil. Autor https://orcid.org/0009-0000-1571-2519
Tiago Guedes Álvares Graduando em Medicina na Universidade Federal de Goiás, Goiânia/GO, Brasil. Autor https://orcid.org/0009-0004-3364-8249
Sofia de Souza Barbosa Carneiro Graduando em Medicina na Universidade Federal de Goiás, Goiânia/GO, Brasil. Autor https://orcid.org/0009-0002-0575-965X
Paulo Henrique de Aquino Junior Médico generalista formado pela Universidade Federal de Goiás, Goiânia/GO, Brasil. Autor https://orcid.org/0000-0002-4244-4350

DOI:

https://doi.org/10.63162/v69n73e26727

Keywords:

Glucagon-like peptide-1 receptor agonists, Gastric emptying, Respiratory aspiration of gastric contents, Fasting, Preoperative care

Abstract

Introduction: Glucagon-like peptide-1 receptor agonists delay gastric emptying, raising concerns regarding the perioperative risk of regurgitation and pulmonary aspiration. Objectives: To synthesise the evidence on delayed gastric emptying and pulmonary aspiration in adults taking GLP-1 receptor agonists undergoing elective procedures and to analyse divergences among recommendations regarding drug withholding and fasting times. Methods: Integrative review conducted according to the six stages described by Souza, Silva and Carvalho, with a search performed on 23 August 2026 in PubMed/MEDLINE and LILACS, complemented by the Cochrane Library. Primary studies in adults published between 2021 and 2026 in Portuguese, English or Spanish were included; medical society documents were analysed separately. Screening was performed by three independent reviewers using the Rayyan platform. Results: Of 132 records identified, 17 composed the synthesis, comprising 14 primary studies and 3 normative documents. Studies assessing residual gastric content consistently showed an association with drug use, with odds ratios ranging from 4.29 to 36.97, greater with recent exposure and nonsignificant after withholding for more than seven days. Studies assessing clinical outcomes found no increased risk of pulmonary aspiration. The recommendations converge on not routinely withholding the drug but diverge regarding prolonged fasting. Conclusions: The dissociation between surrogate and clinical outcomes explains the divergence among recommendations. Current evidence does not allow the issue to be definitively settled.

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