GLP-1 receptor agonists (GLP-1 RAs) are used for the management of type 2 diabetes mellitus and also for weight loss. They are effective in reducing blood sugar levels in diabetic patients and have demonstrated significant results in overweight or obese patients, thus becoming increasingly popular. Delayed gastric emptying in patients taking GLP-1 RAs can lead to an increased risk of aspiration of gastric contents, even with adequate fasting. Several case reports have described aspiration of gastric contents and the presence of solid food on esophagogastroscopy. Stopping these drugs for extended periods can alter glycemic control. Intubating patients for procedures that can be done under sedation can lead to added cost, clinical risks, and procedure time. Various anesthesia societies have issued interim guidelines until further studies regarding the safety of these drugs in the perioperative period are available.
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CAS medication safety bulletin. Toronto (ON): Canadian Anesthesiologists’ Society; 2023 Jun cited 2023 Jul 21. Available from: https://www.cas.ca/CASAssets/Documents/Advocacy/Semaglutide-bulletin_final.pdf
Anesthesiology clinical practice risk alert: GLP-1 agonists used for weight loss and anesthesia considerations for elective surgery memo to all Nova Scotian anesthesiologists and anesthesiology resident physicians. Halifax (NS): Dalhousie University, NS Health Central Anesthesiology Quality and Patient Safety Group; 2023 Jul.
