Gastric ultrasonography allows for real-time evaluation of the stomach's volume and content, which aids in deciding whether anesthesia can be administered safely or whether other safety measures, including rapid sequence induction (RSI), are necessary. Due to the possibility of delayed gastric emptying for patients using GLP-1 receptor agonists, standard fasting recommendations might not be sufficient. Gastric ultrasonography can serve as a useful adjunct for perioperative risk assessment when delayed gastric emptying is suspected. It may be particularly helpful in patients who report gastrointestinal symptoms, those in early stages of GLP-1 therapy, or when the clinician is uncertain about gastric contents despite appropriate fasting.
Handling Emergency or Urgent Cases
Whether fasting or not, patients on GLP-1 receptor agonists should be considered as if they have a "full stomach" when surgery cannot be delayed, such as in emergencies. Safety measures should be taken to reduce the risk of aspiration, including:
- Gastric Decompression: Whenever possible, the stomach should be decompressed using a nasogastric or orogastric tube to minimize the amount of stomach contents before anesthesia induction.
- Rapid Sequence Induction (RSI): RSI is an advanced airway management technique used by anesthesia providers to quickly secure a patient's airway while minimizing the risk of aspiration of gastric contents.
