Retained Gastric Contents After Adequate Fasting Associated with GLP-1 Receptor Agonist Use

Cases: Three patients presented for orthopaedic surgery on glucagon-like peptide receptor agonist (GLP-1 RA) medications with a minimum fasting time of 10 hours. Gastric ultrasound confirmed the presence of retained solids in the stomach; all 3 cases were postponed. Conclusion: There is growing concern for increased perioperative aspiration risk related to delayed gastric emptying associated with GLP-1 RA and a paucity of literature to guide perioperative management. This may cause case cancellation over safety concerns for elective procedures. The presented cases illustrate the association of GLP-1 RA drugs and delayed gastric emptying causing case postponement.