Gastric POCUS for Airway Management in Patients Using Glucagon-like Peptide-1 Receptor Agonist (Multicentric)

• Hypothesis

Gastric ultrasonography performed by trained anesthesiologists is a useful tool for assessing gastric content and may support clinical decision-making in airway management in patients treated with GLP-1 receptor agonists.

• Methodology

This is a prospective, observational cohort study conducted at participating centers.

The study population consists of adult patients undergoing scheduled surgery under general anesthesia following a standard preoperative fasting period.

Inclusion criteria

• Patients receiving treatment with GLP-1 receptor agonists
• Age ≥18 years
• Scheduled surgery after a fasting period between 6 and 8 hours
• ASA physical status I-III
• Ability to provide informed consent

Exclusion criteria

• History of esophagogastric pathology or prior upper abdominal surgery
• Hiatal hernia or gastroesophageal reflux disease
• Autonomic nervous system disorders
• Neurological or neuromuscular diseases
• Use of medications affecting gastric emptying (e.g., opioids or prokinetics)
• Pregnancy
• Presence of clinically significant arrhythmias

• Description of the Intervention

Immediately prior to anesthesia induction, gastric ultrasonography will be performed by trained investigators at participating centers, with the patient in both supine and right lateral decubitus positions.

Qualitative, semi-quantitative, and quantitative assessments of gastric content and volume will be performed according to the methodology described by Perlas et al. Data will be recorded in a standardized study database.

Anesthetic and surgical management will proceed according to routine clinical practice.

• Ethical, Legal, and Economic Considerations

Written informed consent will be obtained from all participants prior to study inclusion.

This is an observational study with no modification of standard clinical care. No additional risks beyond routine clinical practice are anticipated.

Gastric ultrasonography will be performed using equipment available at participating centers, and no additional costs are expected.

• Results

Study data will be analyzed by the investigators. Results will be disseminated through scientific publications and presentations.

Inclusion criteria

Adults patients ,ASA I-III, taking GLP-1 analog medications, undergoing scheduled surgery.

Exclusion criteria

• - History of esophagogastric pathology or previous abdominal surgery.
• - Hiatal hernia/gastroesophageal reflux disease.
• - Autonomic nervous system disorders.
• - Neurological or neuromuscular diseases.
• - Use of medications/drugs that affect autonomic regulation and delay gastric emptying (opioids) or potentiate it (prokinetics).
• - Pregnancy.
• - Presence of arrhythmias.