Hormonal
GLP-1 receptor agonists (GLP-1RA) and dual GLP-1/GIP agonists (e.g., semaglutide, tirzepatide) produce significant weight loss (up to 24.2%) and improve metabolic parameters, but they significantly increase the risk of delayed gastric emptying and perioperative pulmonary aspiration.
If you take semaglutide or tirzepatide, tell your anesthesiologist. These drugs slow down your stomach, which increases the risk of vomiting and inhaling stomach contents during surgery, even if you feel fine. You may need to stop the drug a week before surgery, or your procedure might be delayed. Do not assume standard fasting rules are enough.
Semaglutide had shown a significant reduction in MACE... The FLOW trial... showed a significant effect in slowing the progress of CKD... GLP-1 agonists are known to enhance gastroparesis, and there are legitimate concerns for aspiration during the induction of general anaesthesia.
Why this rating
Based on multiple RCTs (SURMOUNT-1, SURPASS-2, SUSTAIN, FLOW) and systematic reviews cited in the narrative.
Source
The widespread adoption of glucagon-like peptide-1 receptor agonists in the management of obesity and its implications for the anaesthesiologist and intensivist: A narrative review
Taylor E. Browning et al. · 2025
DOI 10.25259/peak_19_2024
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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