BACKGROUND: The use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) is increasing with the expansion of their indications. Their effect on pain and opioid use after surgery is unknown. We hypothesized that GLP-1RA use would be associated with reduced perioperative opioid consumption and pain scores.
METHODS: This is a retrospective cohort study conducted at an academic center. Adult patients undergoing oncological surgery were included in the study. Patients were excluded if they had urgent surgery, were pregnant at the time of surgery, had nonoperating room procedures, or had biopsies or procedures not requiring general anesthesia. Patients who filled GLP-1RA prescriptions within 90 days of surgery were considered GLP-1RA users; those who did not fill prescriptions in the previous 12 months were controls. The association between the use of GLP-1RAs and perioperative opioid consumption and pain intensity after cancer surgery was investigated.
RESULTS: 17,027 patients were included in the study. Of them, 486 patients who used GLP-1RA were matched with 486 non-GLP-1RA users. Intraoperative oral morphine equivalents (OME) were similar for patients on GLP-1RA (74.7 ± 125.51 mg) and non-GLP-1RA users (69.68 ± 123.5 mg; P =.55). In PACU (-0.94; 95% confidence interval [CI], -2.49 to 0.61; P =.23), postoperative day (POD)0 (-0.29; 95% CI, -1.21 to 0.62; P =.52) and POD1 (-1.18; 95% CI, -3.36 to 1.01; P =.29), the difference also did not reach statistical significance. However, we observed a statistically significant reduction in OME in POD2 (-1.98; 95% CI, -3.82 to -0.13, P =.04), and POD3 (-1.94; 95% CI, -3.57 to -0.31, P =.02) in patients taking GLP-1RAs. Our analysis showed no statistically significant differences in pain scores between groups. A linear mixed-effects model demonstrated that the interaction between the treatment cohort and postoperative time was not statistically significant for OME (P =.1) and pain scores (P =.86).
CONCLUSION: GLP-1RA use was not associated with clinically meaningful reductions in perioperative opioid use or pain scores. Further studies should assess if GLP-1RAs are associated with analgesic effects during the perioperative period in other patient populations.
