Effect of various perioperative semaglutide interruption intervals on residual gastric content assessed by esophagogastroduodenoscopy: A retrospective single center observational study

IF 5 2区医学 Q1 ANESTHESIOLOGY Journal of Clinical Anesthesia Pub Date : 2024-10-30 DOI:10.1016/j.jclinane.2024.111668

Leonardo Barbosa Santos MD , Glenio B. Mizubuti MD, PhD , Leopoldo Muniz da Silva MD, PhD , Saullo Queiroz Silveira MD , Rafael Souza Fava Nersessian MD , Arthur de Campos Vieira Abib MD , Fernando Nardy Bellicieri MD , Helidea de Oliveira Lima MD, MSc , Anthony M.-H. Ho MD , Gabriel Silva dos Anjos BS , Diogo Turiani Hourneaux de Moura MD, PhD , Eduardo Guimarães Hourneuax de Moura MD, PhD , Joaquim Edson Vieira MD, PhD

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Abstract

Background

Recent evidence suggests that perioperative semaglutide use is associated with increased residual gastric content (RGC) and risk of bronchoaspiration under anesthesia. We compared the occurrence of increased RGC in semaglutide users and non-users undergoing esophagogastroduodenoscopy to define the time interval at which RGC becomes comparable between groups.

Methods

This was a single-center retrospective electronic chart review at a tertiary hospital. Patients undergoing esophagogastroduodenoscopy under deep sedation/general anesthesia between July/2021–July/2023 were included and divided into two (SG = semaglutide, NSG = non-semaglutide) groups, according to whether they had received semaglutide within 30 days prior to the esophagogastroduodenoscopy. Univariate and multivariate logistic regression were performed to explore which factors were associated with increased RGC, defined as any amount of solid content, or > 0.8 mL/Kg (measured from the aspiration/suction canister) of fluid content.

Results

Among the 1094 (SG = 123; NSG = 971) patients included, increased RGC was observed in 56 (5.12%), being 25 (20.33%) in the SG and 31 (3.19%) in the NSG (p < 0.001). Following weighted analysis, the presence of ongoing digestive symptoms (nausea/vomiting, dyspepsia, and/or bloating/abdominal distension) pre-esophagogastroduodenoscopy [OR = 15.1 (95% confidence interval (CI) 9.85–23.45)] and the time intervals of preoperative semaglutide interruption < 8 days [OR 10.0 (95%CI 6.67–15.65)] and 8–14 days [4.59 (95%CI 2.91–7.37)] remained significantly associated with increased RGC. Following inverse probability treatment weighting adjustment including a composite variable ‘time intervals of semaglutide interruption’ versus ‘presence of ongoing digestive symptoms’, only time intervals > 14 days and without digestive symptoms showed no association with increased RGC [OR = 0.77 (95%CI 0.22–2.01)].

Conclusions

Perioperative semaglutide use is associated with increased RGC in patients undergoing elective esophagogastroduodenoscopy. Preoperative discontinuation of > 21 days and > 14 days in patients with and without ongoing digestive symptoms, respectively, resulted in RGC similar to non-semaglutide users.

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通过食管胃十二指肠镜评估不同围手术期塞马鲁肽中断间隔对残胃内容物的影响：一项回顾性单中心观察研究。

背景：最近的证据表明，围手术期使用塞马鲁肽会增加残胃内容物（RGC）和麻醉下支气管吸入的风险。我们比较了在接受食管胃十二指肠镜检查时使用塞马鲁肽和未使用塞马鲁肽的患者发生 RGC 增加的情况，以确定 RGC 在不同组间具有可比性的时间间隔：这是一项在一家三级医院进行的单中心回顾性电子病历审查。纳入了2021年7月至2023年7月期间在深度镇静/全身麻醉下接受食管胃十二指肠镜检查的患者，并根据患者在接受食管胃十二指肠镜检查前30天内是否接受过塞马鲁肽分为两组（SG=塞马鲁肽组，NSG=非塞马鲁肽组）。我们进行了单变量和多变量逻辑回归，以探讨哪些因素与RGC增加有关，RGC的定义是任何数量的固体内容物，或> 0.8 mL/Kg（从抽吸罐测量）的液体内容物：在纳入的 1094 例（SG = 123 例；NSG = 971 例）患者中，56 例（5.12%）观察到 RGC 增加，其中 SG 25 例（20.33%），NSG 31 例（3.19%）（P 14 天和无消化道症状与 RGC 增加无关[OR = 0.77 (95%CI 0.22-2.01)]）：结论：在择期接受食管胃十二指肠镜检查的患者中，围手术期使用塞马鲁肽与RGC增加有关。有消化道症状和无消化道症状的患者术前分别停药 > 21 天和 > 14 天，其 RGC 与非使用塞马鲁肽者相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Anesthesia 医学-麻醉学

CiteScore

7.40

自引率

4.50%

发文量

346

审稿时长

23 days

期刊介绍： The Journal of Clinical Anesthesia (JCA) addresses all aspects of anesthesia practice, including anesthetic administration, pharmacokinetics, preoperative and postoperative considerations, coexisting disease and other complicating factors, cost issues, and similar concerns anesthesiologists contend with daily. Exceptionally high standards of presentation and accuracy are maintained. The core of the journal is original contributions on subjects relevant to clinical practice, and rigorously peer-reviewed. Highly respected international experts have joined together to form the Editorial Board, sharing their years of experience and clinical expertise. Specialized section editors cover the various subspecialties within the field. To keep your practical clinical skills current, the journal bridges the gap between the laboratory and the clinical practice of anesthesiology and critical care to clarify how new insights can improve daily practice.