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GLP-1 RA Cessation and Gastric Ultrasound Findings

3 juin 2026 mis à jour par: Cheol Lee,MD,PhD,, Wonkwang University Hospital

Time-dependent Association Between Cessation of Glucagon-like Peptide-1 Receptor Agonists and Residual Gastric Contents Assessed by Point-of-care Gastric Ultrasound: a Prospective Observational Study

This prospective observational study will evaluate the association between the time interval since the last dose of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and residual gastric contents before elective surgery. Adult patients receiving GLP-1 RAs and scheduled for elective non-cardiac surgery under general anesthesia will undergo preoperative point-of-care gastric ultrasound. The study will assess whether longer GLP-1 RA cessation intervals are associated with lower ultrasound-estimated gastric volume and a lower frequency of high-risk gastric contents. Body mass index will also be evaluated as a potential modifier of this association.

Aperçu de l'étude

Statut

Complété

Les conditions

Intervention / Traitement

Description détaillée

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used for the treatment of type 2 diabetes and obesity. These agents can delay gastric emptying, raising concerns about residual gastric contents and potential aspiration risk during anesthesia. Current perioperative recommendations regarding GLP-1 RA discontinuation are largely consensus-based, and the physiological relationship between cessation interval and residual gastric content remains insufficiently defined.

This single-center prospective observational cohort study will enroll adult patients who are receiving GLP-1 RAs and are scheduled for elective non-cardiac surgery requiring general anesthesia. GLP-1 RA management will follow usual clinical care; the study team will not assign, modify, or instruct the timing of drug discontinuation. The primary exposure will be the number of days since the last GLP-1 RA dose, analyzed both as a continuous variable and according to prespecified cessation-interval categories.

Immediately before induction of anesthesia, participants will undergo standardized point-of-care gastric ultrasound. Qualitative gastric content will be assessed using the Perlas grading system, and quantitative gastric volume will be estimated from the antral cross-sectional area measured in the right lateral decubitus position. The primary outcome will be estimated gastric volume normalized to body weight. Secondary outcomes will include antral cross-sectional area, Perlas grade, and the presence of high-risk gastric contents.

Multivariable regression models will be used to evaluate the association between GLP-1 RA cessation interval and gastric ultrasound findings after adjustment for clinically relevant covariates, including age, sex, body mass index, diabetes status, preoperative fasting duration, and gastrointestinal symptom score. Body mass index will be evaluated as a prespecified effect modifier.

Type d'étude

Observationnel

Inscription (Réel)

186

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

  • Corée du Sud
    • Jeonbuk-do
      • Iksan, Jeonbuk-do, Corée du Sud, 54538
        • Wonkwang University School of Medicine Hospital

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

  • Adulte
  • Adulte plus âgé

Accepte les volontaires sains

N/A

Méthode d'échantillonnage

Échantillon non probabiliste

Population étudiée

Adult patients receiving glucagon-like peptide-1 receptor agonists who are scheduled for elective non-cardiac surgery requiring general anesthesia at a tertiary academic hospital. Participants will be screened consecutively by the perioperative anesthesia team and enrolled if eligibility criteria are met.

La description

Inclusion Criteria:

  • Adults aged 18 years or older.
  • Patients receiving a glucagon-like peptide-1 receptor agonist.
  • Patients scheduled for elective non-cardiac surgery requiring general anesthesia.
  • Patients able to provide written informed consent.

Exclusion Criteria:

  • Emergency surgery.
  • History of prior gastric surgery.
  • Known gastroparesis or severe gastroesophageal reflux disease.
  • Declined or unable to provide written informed consent.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

Cohortes et interventions

Groupe / Cohorte
Intervention / Traitement
Last GLP-1 RA Dose 3 Days or Less
Participants receiving glucagon-like peptide-1 receptor agonists whose last dose was taken 3 days or less before elective surgery. No intervention was assigned by the study protocol; GLP-1 RA management followed usual clinical care. Participants underwent preoperative point-of-care gastric ultrasound to assess residual gastric contents.
Autre: GLP-1 RA Cessation Interval
Observed exposure defined as the number of days between the participant's last glucagon-like peptide-1 receptor agonist dose and elective surgery. Participants were categorized according to time since last dose: 3 days or less, 4 to 7 days, and 8 days or more. No GLP-1 receptor agonist was assigned, administered, continued, or discontinued by the study protocol; medication management followed usual clinical care.
Autres noms:
  • Time Since Last GLP-1 RA Dose
  • GLP-1 RA Discontinuation Interval
Last GLP-1 RA Dose 4 to 7 Days
Participants receiving glucagon-like peptide-1 receptor agonists whose last dose was taken 4 to 7 days before elective surgery. No intervention was assigned by the study protocol; GLP-1 RA management followed usual clinical care. Participants underwent preoperative point-of-care gastric ultrasound to assess residual gastric contents.
Autre: GLP-1 RA Cessation Interval
Observed exposure defined as the number of days between the participant's last glucagon-like peptide-1 receptor agonist dose and elective surgery. Participants were categorized according to time since last dose: 3 days or less, 4 to 7 days, and 8 days or more. No GLP-1 receptor agonist was assigned, administered, continued, or discontinued by the study protocol; medication management followed usual clinical care.
Autres noms:
  • Time Since Last GLP-1 RA Dose
  • GLP-1 RA Discontinuation Interval
Last GLP-1 RA Dose 8 Days or More
Participants receiving glucagon-like peptide-1 receptor agonists whose last dose was taken 8 days or more before elective surgery. No intervention was assigned by the study protocol; GLP-1 RA management followed usual clinical care. Participants underwent preoperative point-of-care gastric ultrasound to assess residual gastric contents.
Autre: GLP-1 RA Cessation Interval
Observed exposure defined as the number of days between the participant's last glucagon-like peptide-1 receptor agonist dose and elective surgery. Participants were categorized according to time since last dose: 3 days or less, 4 to 7 days, and 8 days or more. No GLP-1 receptor agonist was assigned, administered, continued, or discontinued by the study protocol; medication management followed usual clinical care.
Autres noms:
  • Time Since Last GLP-1 RA Dose
  • GLP-1 RA Discontinuation Interval

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Estimated Gastric Volume Normalized to Body Weight
Délai: Immediately before induction of anesthesia on the day of surgery
Estimated gastric volume normalized to body weight, expressed as mL/kg, calculated from the antral cross-sectional area measured by preoperative point-of-care gastric ultrasound in the right lateral decubitus position.
Immediately before induction of anesthesia on the day of surgery

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Antral Cross-Sectional Area
Délai: Immediately before induction of anesthesia on the day of surgery
Antral cross-sectional area measured by preoperative point-of-care gastric ultrasound in the right lateral decubitus position and expressed in cm2.
Immediately before induction of anesthesia on the day of surgery
Perlas Gastric Ultrasound Grade
Délai: Immediately before induction of anesthesia on the day of surgery
Qualitative gastric content will be assessed using the Perlas Gastric Ultrasound Grading System, which ranges from Grade 0 to Grade 2. Grade 0 indicates an empty stomach, Grade 1 indicates fluid visible only in the right lateral decubitus position, and Grade 2 indicates fluid visible in both the supine and right lateral decubitus positions. Higher grades indicate greater residual gastric content.
Immediately before induction of anesthesia on the day of surgery
Gastrointestinal Symptom Score
Délai: Within 24 hours before surgery
Preoperative gastrointestinal symptoms will be assessed using a Gastrointestinal Symptom Numeric Rating Scale for nausea, vomiting, bloating, early satiety, and abdominal discomfort. Each symptom is rated from 0 to 10, where 0 indicates no symptom and 10 indicates the worst imaginable symptom. The total score ranges from 0 to 50, with higher scores indicating more severe gastrointestinal symptoms.
Within 24 hours before surgery

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Wonkwang University Hospital

Les enquêteurs

  • Directeur d'études: Cheol Lee, M.D.,Ph.D, Wonkwang University Hosptial

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

4 février 2026

Achèvement primaire (Réel)

27 mars 2026

Achèvement de l'étude (Réel)

20 mai 2026

Dates d'inscription aux études

Première soumission

28 mai 2026

Première soumission répondant aux critères de contrôle qualité

28 mai 2026

Première publication (Réel)

3 juin 2026

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

5 juin 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

3 juin 2026

Dernière vérification

1 juin 2026

Plus d'information

Termes liés à cette étude

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • Wonkwang UH25

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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