All patients taking GLP-1 agonists should be considered as at risk of having a full stomach despite a lack of gastrointestinal symptoms. (CPS)

Whenever possible, a gastric ultrasound should be performed. If gastric contents are found by ultrasound and these are considered as a high risk for aspiration, patients should be counselled about this risk before deciding to proceed with sedation/general anaesthesia. (CPS)

If the procedure is of such urgency that postponement is not desirable, endotracheal intubation by rapid sequence induction/intubation is advised. (CPS)

SGLT2 inhibitors (SGLT2i) drugs should be withheld for 3 to 4 days before elective procedures to reduce the risk of euglycemic diabetic ketoacidosis. (CPS)

Patients taking SGLT2i medications should consume clear fluids approximately 2 h before the procedure to keep regular hydration. (CPS)

Euglycemic diabetic ketoacidosis should be suspected in this category of patients, and blood β-hydroxybutyrate (BOHB) is a functional confirmatory test. (CPS)

If a patient taking SGLT2i drugs did not discontinue the medication in time, dehydration caused by bowel preparation for endoscopy can increase the ketone levels, and the patient should be adequately hydrated before leaving the hospital. (CPS)

We recommend an early outpatient preoperative anaesthesia assessment to reduce day-of-surgery cancellations and length of hospital stay. (1C)

We recommend that telemedicine and standardised questionnaires be used as part of the preoperative anaesthesia assessment to improve patient accessibility to preanaesthesia care and their satisfaction. (1B)

We suggest performing the preoperative assessment before the day of surgery, preferably within 30 days. However, we advise an updated comprehensive review by the attending anaesthetist within the 48 h before surgery. (CPS)