In June, the American Society of Anesthesiologists reported anecdotal evidence of GLP-1s resulting in regurgitation and aspiration in surgeries. The drugs delay gastric emptying, meaning normal fasting rules weren’t enough for normal preoperative strategies, so the ASA recommended patients miss a dose. The American Association of Nurse Anesthesiology published a similar guidance in March.
Other experts acknowledged seeing similar anecdotal evidence but said the guidelines were an overreaction and created more issues. The American Gastroenterological Association called the issue a “clinical dilemma,” adding that too many surgeries were canceled due to a perceived risk.
In a study published April 22 in JAMA, Stanford Medicine researchers evaluated more than 23,000 patient records to investigate the surgical risks associated with GLP-1 use.
They found none.
“Overall incidence of postoperative respiratory complications was 3.5% for those with a GLP-1 RA fill and 4% for those without,” they wrote. “Results of this study suggest that liberalizing the withholding guidelines for GLP-1 RAs preoperatively should be considered.”
