Glucagon-like peptide-1 receptor agonists in peri-operative care

📖 Top 20% JournalDec 2, 2024European journal of anaesthesiology

Glucagon-like peptide-1 receptor drugs in surgery care: clarifying misunderstandings and important points for anesthesiologists

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Abstract

GLP-1 receptor agonists may increase levels of gastroparesis during the peri-operative period.

Gastroparesis is associated with concerns regarding the safety of anesthesia induction.
Current evidence suggests an increased level of gastroparesis among patients using GLP-1 receptor agonists.
No studies have confirmed an elevated risk of pulmonary aspiration linked to GLP-1 receptor agonist use.
Future research should investigate the actual risk of pulmonary aspiration in these patients.
The implementation of ultrasound in preoperative assessments is suggested for better evaluation.

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With the growing use of glucagon-like-peptide-1 (GLP-1) receptor (GLP-1R) agonists as anti-obesity medication it is becoming increasingly important to examine its consequences in the peri-operative period. GLP-1R agonists are known for their effects of glucose-lowering and gastroparesis the latter causing some safety concerns regarding induction of anaesthesia, more specifically the risk of pulmonary aspiration. This article gathers the available evidence on this subject in addition to the already established guidelines. Current evidence makes us assume there is indeed an increased level of gastroparesis, but there are no studies to date with evidential confirmation of a presumed elevated risk of pulmonary aspiration. Future perspectives should focus on the actual risk of pulmonary aspiration and the possible implementation of ultrasound in the preoperative assessment.

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