807-P: GLP-1 Agonists and the Risk of Delayed Gastric Emptying in Elective Ophthalmic Procedures

Introduction & Objective: Concerns arise over delayed gastric emptying with Glucagon-like peptide-1 (GLP-1) receptor agonists in elective procedures. This study, in line with American Society of Anesthesiologists (ASA) guidelines, assesses perioperative effects, including evaluations of ASA scores and surgical outcomes, to address limited evidence highlighted by the ASA Task Force on Preoperative Fasting.

Methods: A three-month prospective chart review of patients undergoing ocular surgery with conscious sedation and a retrobulbar block with specific ASA preoperative instructions. When possible, patients on oral doses were instructed to hold the medication for 24 hours before surgery, while those receiving subcutaneous weekly doses were required to hold medication for one week and adhere to a clear liquid diet for 24 hours before surgery and maintain NPO status after midnight. Independent variables, including preoperative instructions and patient compliance, along with dependent variables such as preoperative blood sugar levels and complications, were analyzed.

Results: The prospective research study involved 20 participants, 6 males (30%) and 14 females (70%), with an average age of 68 years (SD: 9, range 54 to 88). Preoperative instructions were provided to 14 participants (70%), and there was complete compliance among the patients. The mean ASA score was 2.7 (SD: 0.57, range 2 to 4), and average preoperative glucose levels were 122 (SD: 29.4, range 95 to 210). There were no documented cases of aspiration and no difference between individuals who received preoperative instructions and those who did not, concerning glucose levels, coughing, desaturations, and the need for a jaw thrust in both scheduled and emergent surgeries.

Conclusion: Adhering to preoperative ASA guidelines, our results reveal no instances of aspiration despite concerns about delayed gastric emptying, offering insights into the safety and compliance implications of GLP-1 use in this patient group.