Gastric Emptying Recovery After GLP-1 RA Cessation

NCT07360262 | Completed DMC

• 1 other identifier: Wonkwang UH 23
• Study Type: observational
• Target: 186
• Locations: 1 country
• Sites: 2

Brief Summary

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) can delay gastric emptying and may increase residual gastric contents before general anesthesia. Current perioperative recommendations for withholding GLP-1 RAs (e.g., a fixed 7-day discontinuation for weekly agents) are largely consensus-based, and it is unclear whether gastric emptying normalizes abruptly after a single threshold interval. This prospective observational cohort study will evaluate how preoperative residual gastric content changes with increasing time since the last GLP-1 RA dose, using point-of-care gastric ultrasound performed immediately before induction of anesthesia. Time since last dose will be analyzed as a continuous exposure and across prespecified intervals (≤3 days, 4-7 days, ≥8 days). The primary outcome is ultrasound-estimated gastric volume normalized to body weight (mL/kg), derived from antral cross-sectional area. Secondary outcomes include the presence of a "high-risk stomach" based on gastric volume criteria and qualitative ultrasound findings. The study will also assess whether body mass index modifies the relationship between cessation interval and gastric volume, thereby supporting individualized perioperative risk assessment.

Conditions

Gastric Emptying; Gastroparesis; Preoperative Care

Keywords

GLP-1 receptor agonist; GLP-1 RA cessation / withholding interval; Point-of-care ultrasound / POCUS; Gastric ultrasound; Residual gastric volume

Outcome Measures

Primary Outcomes (1)

• Ultrasound-estimated gastric volume (mL/kg)

  Estimated gastric volume normalized to body weight (mL/kg) was calculated from the gastric antral cross-sectional area measured by preoperative point-of-care ultrasound using validated equations.

  Immediately preoperatively (just before induction of anesthesia)

Secondary Outcomes (2)

• Perlas grade of gastric content (0-2)

  Immediately preoperatively (just before induction of anesthesia)

• Antral cross-sectional area (CSA, cm²)

  Immediately preoperatively (just before induction of anesthesia)

Study Arms (3)

GLP-1 RA cessation ≤3 days

Participants using GLP-1 receptor agonists whose last dose was taken ≤3 days before the preoperative gastric ultrasound assessment (performed immediately prior to induction of anesthesia).

Other: Preoperative gastric ultrasound

GLP-1 RA cessation 4-7 days

Participants using GLP-1 receptor agonists whose last dose was taken 4-7 days before the preoperative gastric ultrasound assessment (performed immediately prior to induction of anesthesia).

Other: Preoperative gastric ultrasound

GLP-1 RA cessation ≥8 days

Participants using GLP-1 receptor agonists whose last dose was taken ≥8 days before the preoperative gastric ultrasound assessment (performed immediately prior to induction of anesthesia).

Other: Preoperative gastric ultrasound

Interventions

Preoperative gastric ultrasound OTHER

Preoperative point-of-care gastric ultrasound was performed immediately prior to induction of anesthesia to assess qualitative gastric content and to estimate gastric volume from antral cross-sectional area. The procedure was observational and was applied to all cohorts; no study-assigned treatment was administered or modified.

Also known as: Point-of-care gastric ultrasound (Gastric POCUS)

GLP-1 RA cessation 4-7 days; GLP-1 RA cessation ≤3 days; GLP-1 RA cessation ≥8 days

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adult patients receiving GLP-1 receptor agonists who were scheduled for elective surgery under general anesthesia at a tertiary academic hospital and underwent preoperative point-of-care gastric ultrasound immediately prior to induction of anesthesia.

You may qualify if:

• Adults aged ≥18 years
• Receiving a glucagon-like peptide-1 receptor agonist (GLP-1 RA)
• Scheduled for elective surgery under general anesthesia
• Able to provide written informed consent

You may not qualify if:

• Prior gastric or esophageal surgery
• Known gastroparesis
• Severe gastroesophageal reflux disease
• Emergency surgery
• Pregnancy
• Inability to provide informed consent

Sponsors & Collaborators

• Wonkwang University Hospital: lead

Study Sites (2)

Wonkwang University Hospital

Iksan, Jeollabuk-do, 54538, South Korea

Location

Wonkwang University School of Medicine Hospital

Iksan, Jeollabuk-do, 54538, South Korea

Location

MeSH Terms

Conditions

Gastroparesis

Condition Hierarchy (Ancestors)

Stomach Diseases; Gastrointestinal Diseases; Digestive System Diseases; Paralysis; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Cheol Lee, M.D.,Ph.D

  Wonkwang University Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: January 13, 2026
• First Posted: January 22, 2026
• Study Start: November 20, 2025
• Primary Completion: December 10, 2025
• Study Completion: January 12, 2026
• Last Updated: January 23, 2026

Record last verified: 2026-01

Locations

KR (2)