Clinical Research Directory

Investigation of Gastric Emptying by Gastric Ultrasonography in Diabetic Patients Treated With GLP-1 Receptors

Treatment with semaglutide slows down gastric emptying , food remains in the stomach for a longer period of time. This slowing has important implications for anesthesia management. At present, we do not know the optimal duration for discontinuing this medication before surgery and anesthesia to ensure an empty stomach. This is an observational research project, conducted exclusively at the Geneva University Hospitals (HUG). To answer the research question, participation of 38 individuals will be required. The duration of participation for each person is 7 days. To recruit the necessary number of participants, approximately 1.5 years will be needed. This project is being carried out in accordance with Swiss legal requirements and recognized international guidelines. The competent ethics committee has reviewed and approved this project. The project will last 7 day during which the participants will need to come 3 times at the hospital to make gastric ultrasounds. On these days the participants will be asked to have a breakfast between 7 and 8 am including a minimum of bread and/or cereals and/or proteins. After that the participants will be asked to fast for 6 hours for solide food and 2 hours for liquids. If the participants smokes, they must for 12h before the exam. At 2Pm an anesthesiologist will welcome the participant to make the exam at the hospital to evaluate the gastric volume after what the participants will be able to get a small collation and go back home.

Gastric Emptying With Metoclopramide in GLP-1 Agonist Patients Undergoing Elective Surgery

This is a multicentre, investigator-blinded, randomised controlled trial evaluating whether the use of oral metoclopramide before surgery can reduce the amount of residual gastric content in patients who are taking glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for weight loss. These medications are known to slow down gastric emptying, which may increase the risk of pulmonary aspiration during anaesthesia. Patients will be randomly assigned to either receive metoclopramide 24 hours before surgery or continue with standard care. The primary outcome will be the presence or absence of residual gastric content on ultrasound before surgery. Secondary outcomes include nausea, vomiting, constipation, and any adverse effects of the medication.

Effects of Beginning a GLP1-Agonist Therapy on Residual Gastric Content and Gastric Emptying

This project explores the elevated risk of pulmonary aspiration during anesthesia in patients undergoing GLP-1 agonist therapy, which prolongs gastric emptying. Despite standard fasting guidelines (6 hours for solids, 2 hours for liquids), some patients still experience aspiration, indicating that GLP-1 therapy may heighten risk. The American Society of Anesthesiologists has advised pausing GLP-1 therapy before surgery, but this recommendation has faced criticism for being too broad. More data on this issue is needed, particularly concerning the effect of tachyphylaxis (reduced drug response over time) on gastric emptying. The study proposes using gastric ultrasound as a non-invasive tool to evaluate residual gastric content and categorize patients by their aspiration risk. The study will assess the stomach's content and gastric emptying time in patients both before and after starting GLP-1 therapy, comparing results under standard fasting conditions. The project is a national, single-center, prospective observational study targeting 50 patients, examining factors like patient demographics, GLP-1 therapy details, and gastrointestinal side effects. Data collection will occur through baseline and follow-up sonographic exams before and after therapy initiation. The study aims to improve perioperative management strategies by clarifying the risks associated with GLP-1 therapy