Perioperative management of patients on glucagon-like peptide-1 receptor agonists

Feb 23, 2024Current opinion in anaesthesiology

Managing patients taking glucagon-like peptide-1 medicines around the time of surgery

AI simplified

GLP-1 Therapies on OpenScience ↗PubMed ↗DOI ↗

Abstract

GLP-1 receptor agonists may increase the risk of bronchoaspiration during the perioperative period.

GLP-1 receptor agonists are known to delay gastric emptying.
Recent anecdotal evidence suggests that their perioperative use could lead to complications, primarily bronchoaspiration.
Current guidelines recommend caution regarding the use of GLP-1-RAs during surgery, especially under general anesthesia or deep sedation.
High-quality studies are needed to clarify the safety of preoperative cessation and optimal fasting intervals for specific GLP-1-RA agents.
Clinicians should be mindful of the potential risks linked to perioperative GLP-1-RA use.

AI simplified

PURPOSE OF REVIEW: To summarize the mechanism of action, clinical outcomes, and perioperative implications of glucagon-like peptide-1 receptor agonists (GLP-1-RAs). Specifically, this review focuses on the available literature surrounding complications (primarily, bronchoaspiration) and current recommendations, as well as knowledge gaps and future research directions on the perioperative management of GLP-1-RAs.

RECENT FINDINGS: GLP-1-RAs are known to delay gastric emptying. Accordingly, recent case reports and retrospective observational studies, while anecdotal, suggest that the perioperative use of GLP-1-RAs may increase the risk of bronchoaspiration despite fasting intervals that comply with (and often exceed) current guidelines. As a result, guidelines and safety bulletins have been published by several Anesthesiology Societies.

SUMMARY: While rapidly emerging evidence suggests that perioperative GLP-1-RAs use is associated with delayed gastric emptying and increased risk of bronchoaspiration (particularly in patients undergoing general anesthesia and/or deep sedation), high-quality studies are needed to provide definitive answers with respect to the safety and duration of preoperative drug cessation, and optimal fasting intervals according to the specific GLP-1-RA agent, the dose/duration of administration, and patient-specific factors. Meanwhile, clinicians must be aware of the potential risks associated with the perioperative use of GLP-1-RAs and follow the recommendations put forth by their respective Anesthesiology Societies.

Full Text

Full text is available at the source.

View full text ↗

Perioperative management of patients on glucagon-like peptide-1 receptor agonists

Abstract

Full Text

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief

Abstract

Full Text

Related papers

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief