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[6] [7] Current 2024 multi-society guidance from the ASA and other professional organizations suggests a risk-stratified approach: For most patients : Continue tirzepatide with appropriate precautions, such as a 24-hour clear liquid diet before surgery and consideration of point-of-care gastric ultrasound For high-risk patients : Consider holding one dose or implementing modified fasting protocols if patients are in the dose-escalation phase, experiencing active GI symptoms, on high doses, or have comorbid gastroparesis For urgent or emergent procedures : Surgery should not be delayed, but anesthesiologists should treat patients as having a full stomach and employ rapid sequence induction techniques This updated approach represents an evolution from earlier recommendations that suggested holding the medication for 7 days or longer before surgery