Hormonal
GLP-1 receptor agonists delay gastric emptying and increase the risk of pulmonary aspiration during general anesthesia, necessitating specific peri-operative management strategies.
If you take a GLP-1 drug (like Ozempic, Wegovy, or Trulicity) and have surgery, tell your anesthesiologist. You likely need to stop the drug for a specific time before surgery (often 3 half-lives, e.g., 1 week for weekly drugs) to prevent stomach contents from entering your lungs while asleep. Do not assume standard fasting rules apply; your stomach may still be full even if you haven't eaten for 12 hours.
In patients using glucagon-like peptide-1 receptor agonists, a key concern in the peri-operative period is the increased risk of pulmonary aspiration due to delayed gastric emptying.
Why this rating
Evidence is based on case reports, case series, and observational studies; no randomized controlled trials on aspiration rates were found.
Source
Glucagon‐like peptide‐1 receptor agonists: a narrative review of clinical pharmacology and implications for peri‐operative practice
David A. Milder et al. · Anaesthesia · 2024
DOI 10.1111/anae.16306
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- Withholding GLP-1 receptor agonists for at least three half-lives before elective surgery is recommended for weight management patients to minimize retained gastric contents.Moderate
- For patients with Type 2 Diabetes, prolonged cessation of GLP-1 receptor agonists may worsen peri-operative glycaemic control, requiring individualized management and endocrinologist consultation.Moderate
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