Most patients may continue to safely take glucagon-like peptide-1 (GLP-1) receptor agonists as prescribed before undergoing elective surgery and GI endoscopies, according to new clinical guidance published Oct. 29 by AGA, the American Society for Metabolic and Bariatric Surgery (ASMBS), the American Society of Anesthesiologists (ASA), the International Society of Perioperative Care of Patients with Obesity (ISPCOP), and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES).
While in most cases patients can continue to take the drugs, individual risk factors for complications should be assessed prior to surgery. The guidance cautions that patients at high risk for significant GI side effects should follow a liquid diet for 24 hours before a procedure and the anesthesia plan be adjusted accordingly. In rare cases, the procedure should be delayed.
GLP-1s, used to treat obesity, diabetes and heart problems, delay gastric emptying, and residual food or liquid in the stomach at the time of surgery with general anesthesia, may increase the risk for serious complications including aspiration. On the other hand, withholding medication so patients can have surgery may be even riskier, prompting the new guidance. It is also important to note that the risk of delayed gastric emptying decreases over time for most patients on these medications.
Review the full guidance published in Clinical Gastroenterology and Hepatology.
