Patients can generally continue taking glucagon-like peptide-1 (GLP-1) receptor agonists before elective surgeries and gastrointestinal endoscopies, according to new guidance from five leading medical societies. These include the American Society for Metabolic and Bariatric Surgery (ASMBS), the American Society of Anesthesiologists (ASA), the American Gastroenterological Association (AGA), the International Society of Perioperative Care of Patients with Obesity (ISPCOP), and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES).
The guidance, published in multiple medical journals, advises that patients at high risk for gastrointestinal complications should follow a liquid diet for 24 hours before their procedure. Additionally, their anesthesia plans may need adjustment. In some rare cases, it might be necessary to delay the procedure.
GLP-1 medications are commonly used to treat obesity, diabetes, and heart problems. They work by delaying gastric emptying, which means food or liquid can remain in the stomach when a patient is under general anesthesia. This situation can raise the risk of serious complications, such as aspiration. However, stopping these medications before surgery can pose its own risks, which led to the development of this new guidance. It is also noted that the risk of delayed gastric emptying tends to decrease over time for most patients on these medications.
Dr. Ann M. Rogers, President of ASMBS, emphasized the importance of raising awareness about safety concerns related to GLP-1 medications. The authors of the guidance aim to provide a unified approach to safely managing patients on GLP-1RA therapy, regardless of their health conditions, during the time surrounding surgical procedures.
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