British journal of anaesthesiaOct 29, 2025

Could drugs that activate GLP-1 receptors provide overall benefits during surgery?

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Jun 27, 2026

Abstract

Essence

GLP-1 receptor agonist use may have a more complex perioperative risk-benefit profile than aspiration concerns alone suggest.

Evidence

This commentary-style review discusses large retrospective studies and a new observational study on GLP-1RA use, full-stomach presentations, periprocedural aspiration, mortality, cardiovascular risk, and other outcomes.

Caveat

The evidence is observational and described as seriously limited in key retrospective studies, so it cannot settle whether GLP-1RA use causes perioperative benefit or aspiration risk.

Simplified

Despite a clear association with an increased incidence of unsuspected full stomach presentations, and the release of numerous societal guidelines recommending caution, the relation between glucagon-like peptide-1 receptor agonist (GLP-1RA) use and periprocedural pulmonary aspiration is debatable. Several large retrospective studies (with serious limitations) have found risk either slightly increased or, more commonly, unchanged, compared with non-users. Completing these findings, a new observational study demonstrates a substantial inverse relation, in association with improvement in mortality, cardiovascular risk, and a host of other outcomes. These surprising and fortunate findings recall a multitude of recently demonstrated beneficial effects of GLP-1RA therapy in nonsurgical patients, and reveals a complex, potentially bidirectional relationship between GLP-1RA use and the risk of periprocedural aspiration.