Ozempic and other GLP-1 drugs may increase surgical complications

Dr. Sen led a small study of 124 patients scheduled for elective, non-emergency surgery. Half of the patients were prescribed a GLP-1 RA, while the other half (control group) were not taking the drug. The average age of the participants was 56 years, and the majority (60%) were female.

Using a technique known as Gastric ultrasoundThe researchers were able to assess the contents of the patients' stomachs before anesthesia. Residual gastric contents were defined as three different types of contents in the stomach: solid, thick liquid, or clear liquid exceeding 1.5 ml/kg.

More than half (56%) of patients using GLP-1 RA had increased gastric content volume compared to only 19% of the control group. After further statistical analysis, this study shows that GLP-1 RA is associated with a 30% increased likelihood of gastric retention compared to controls.

“This study definitely addresses a timely question because these drugs are in so much use right now. For surgeons, we don't know what to do with these…drugs.” Dr.Cindy Kin An associate professor of surgery at Stanford University told Healthline: “This raises some new questions.”

according to 2009 study by the American Society of Anesthesiologistsaspiration of gastric contents contributes to up to 9% of all anesthesia-related deaths.

Aspiration of the lungs can cause aspiration pneumonia, a serious lung infection that can lead to respiratory failure and death. According to some researchers, this type of pneumonia can cause up to 70% mortality, depending on the amount and type of aspirate. study.

a study From 2023 onwards, the incidence of anesthesia aspiration events is estimated to be between 2 and 7 per 20,000.

Although there is an association between retained gastric contents and the risk of aspiration, the new study does not show a clear link between GLP-1 RA and pulmonary aspiration, a serious potential complication. do not have.

“The data linking fullness to the risk of aspiration have not been studied, but it is just a predictor that these patients are at increased risk of stomach contents entering the lungs,” Sen said.

Dr. Mark Schutta, A professor of diabetes at Penn Medicine and medical director of the Penn-Rodbaugh Diabetes Center told Healthline that attention should be paid not only to stomach contents, but also to the number of aspiration events, which were not investigated in this study. , the value of this research is limited.

“This is a small study. This is 124 patients, right? I don't think we can draw any firm conclusions. The real question to me, and the results we need to know, is the actual occurrence of aspiration. “That's what we're concerned about,” he said.

“Perhaps people who take this drug have more residual gastric contents than those who don't, but the question is whether that is clinically important.” Schutta added.

The main question this study raises is how surgeons and anesthesiologists should prepare patients taking GLP-1 RAs for surgery.

However, the answer to that question is not yet clear.

Currently, the American Society of Anesthesiologists recommends that patients take these medications weekly. Please stop taking this medicine one week before surgery.

It is not yet clear what the fasting guidelines, also known as “fasting guidelines,” are. Status as a NPO, should be modified for patients taking GLP-1 RAs. Future research will be needed to learn how or if these guidelines should be updated.

But for now, people taking GLP-1 RAs and planning to have surgery should make sure their doctor knows their medication history.

“This is a new drug, but very little is known about the perioperative risks. So anyone taking this drug should definitely tell their surgeon, 'Hey, I'm taking this GLP-1.' I should tell you. Is there anything special I need to do? ” Kin said.

“This is just preliminary evidence, and more data and different types of studies will be needed to really guide us and anesthesiologists,” Schutta said.

People taking GLP-1 RA, obesity and diabetes medications such as Ozempic and Munjaro should be aware of potential complications from surgery.

GLP-1 RA slows digestion, which can result in residual gastric contents during surgery, which is a risk factor for pulmonary aspiration.

Aspiration of the lungs can lead to aspiration pneumonia, an infection of the lungs that can cause respiratory failure and death.