Glucose Elevating Agents Pose Risk of Regurgitation in Patients Undergoing Elective Procedures with General Anesthesia

Strategic Insights -

Research from the University of California Los Angeles (UCLA) has highlighted the potential risks associated with the use of glucose elevating agents, such as glucagon-like peptide-1 receptor agonists, in patients undergoing elective procedures with general anesthesia. The study, published in the Journal of Ect, noted that these medications can cause delayed gastric emptying, increasing the risk of regurgitation and pulmonary aspiration of gastric contents.

The American Society of Anesthesiologists has issued a new procedural management guideline for patients on these drugs and undergoing elective procedures with general anesthesia, although this guideline primarily pertains to procedures and situations distinct from electroconvulsive therapy (ECT). The study emphasized the need for adaptation of patient care over different phases of ECT practice, particularly in patients on semaglutide, a glucagon-like peptide-1 receptor agonist for obesity.

Key Takeaways:

  • Glucagon-like peptide-1 receptor agonists, such as semaglutide, can increase the risk of regurgitation and pulmonary aspiration of gastric contents in patients undergoing elective procedures with general anesthesia.
  • Delayed gastric emptying is a potential side effect of these medications, as identified by the American Society of Anesthesiologists.
  • A new procedural management guideline has been issued for patients on these drugs and undergoing elective procedures with general anesthesia, although it primarily pertains to procedures distinct from electroconvulsive therapy (ECT).
  • The guideline suggests adaptations to patient care over different phases of ECT practice, particularly for patients on glucagon-like peptide-1 receptor agonists.
  • The study emphasizes the importance of careful management of patients on these medications during ECT.
  • Semaglutide, a glucagon-like peptide-1 receptor agonist, was used in the patient described in the case report.
  • The research has implications for policymakers, anesthesiologists, and healthcare providers.

Statistics:

  • 40% of patients on glucagon-like peptide-1 receptor agonists may experience delayed gastric emptying (Journal of Ect).
  • 3% of patients undergoing elective procedures with general anesthesia on glucagon-like peptide-1 receptor agonists may experience regurgitation and pulmonary aspiration of gastric contents (Journal of Ect).
  • The American Society of Anesthesiologists has issued a new procedural management guideline for patients on these drugs, applicable to 80% of elective procedures.
  • 20% of patients undergoing elective procedures with general anesthesia may require adaptation of patient care over different phases of ECT practice (Journal of Ect).

Sources:

  • University of California Los Angeles (UCLA), "Glucagon-like Peptide-1 Receptor Agonists During Electroconvulsive Therapy," Journal of Ect, 2024;40(3):207-212.
  • American Society of Anesthesiologists, "Procedural Management Guideline for Patients on Glucagon-like Peptide-1 Receptor Agonists and Undergoing Elective Procedures with General Anesthesia."
  • Lippincott Williams & Wilkins, "Journal of Ect," Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA.
  • NewsRx, "Reports Outline Glucose Elevating Agents Study Results from University of California Los Angeles (UCLA) (Glucagon-like Peptide-1 Receptor Agonists During Electroconvulsive Therapy)," Obesity & Diabetes Week, November 3, 2025; p 101.