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GLP-1 agonist and aspiration risk — FRCA Final MCQ

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HardPerioperative MedicineGLP-1 agonist and aspiration riskFRCA Final

A 61-year-old man taking semaglutide for obesity attends for elective sleeve gastrectomy. He reports persistent nausea, early satiety and vomiting during the preoperative week. Airway assessment is reassuring, but he has reflux symptoms on the day of surgery. What is the most appropriate anaesthetic technique?

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Correct answer: E — Treat as increased aspiration risk and consider postponement after multidisciplinary discussion

GLP-1 receptor agonists may be associated with delayed gastric emptying, and active gastrointestinal symptoms increase aspiration concern. The appropriate response is individual risk assessment, aspiration precautions and possible postponement depending on urgency and symptom severity. A normal airway assessment does not remove gastric risk. Supraglottic airway sedation is unsuitable for symptomatic reflux in bariatric surgery.

Reference: CPOC/Association of Anaesthetists GLP-1 peri-operative consensus guidance 2025