Glucagon-Like Peptide 1 Receptor Agonist Use Before Surgery / Reply

Sen et al found an association between the usage of glucagon-like peptide 1 receptor agonists (GLP- 1 RAs) and an increased prevalence of residual gastric content (RGC) before anesthesia. These results confirm previous findings in upper endoscopy patients and volunteers. They also published "an exploratory analysis of the association between the duration of GLP- 1 RA discontinuation and increased RGC". We write to urge readers not to overinterpret the results of this particular analysis. We have previously suggested stopping semaglutide for up to 3 weeks before surgery, a suggestion incongruent with the American Society of Anesthesiologists guidance of a 1-week preoperative holding period.