August 6, 2024 from Fox News
Patients taking GLP-1 medications such as Ozempic, Wegovy, or Mounjaro are at higher risk of complications during surgery, recent studies suggest. GLP-1 (glucagon-like peptide) receptor agonists are commonly prescribed to patients with type 2 diabetes or obesity to help stabilize blood glucose levels or aid in weight loss. However, these medications can slow digestion, increasing the risk of serious issues during surgery, including pulmonary aspiration and delayed recovery.
What the Research Shows
A study conducted by UTHealth Houston found that over half of the patients taking GLP-1 medications had significant gastric contents before surgery, even after following pre-operative fasting guidelines. This raises the risk of pulmonary aspiration, a condition in which food or liquid is inhaled into the lungs, potentially causing severe damage, infections, or even death.
“These medications slow down digestion, which means food stays in the stomach longer,” explained Dr. Alfred Bonati, founder of the Bonati Spine Institute. This slow digestion is a primary cause of the heightened risk, as general anesthesia can induce nausea, further increasing the chance of vomiting during surgery.
Additional Complications and Risks
In addition to the risk of pulmonary aspiration, Dr. Brett Osborn, a neurosurgeon and section chief at St. Mary’s Medical Center in Florida, warns of another complication: postoperative ileus. This condition, where the intestines temporarily stop functioning after surgery, can lead to significant health problems, including bowel ischemia.
Osborn also highlights the impact of GLP-1 medications on recovery. “Patients on these medications often follow a hypocaloric diet, which can inhibit healing and recovery from surgery,” he explained. Proper nutrition, especially a protein-rich diet, is crucial for tissue recovery, and the reduced caloric intake common among patients taking GLP-1 agonists may slow down this process.
Expert Recommendations for Surgery
Due to these risks, experts recommend pausing GLP-1 medications like Ozempic before surgery. The American Society of Anesthesiologists (ASA) has issued guidelines advising patients to stop these medications in the days or weeks leading up to elective procedures. The timing for pausing depends on the specific medication and the type of surgery. Dr. Osborn typically advises his patients to stop taking GLP-1 agonists at least one week before surgery.
Dr. Jean-Carlos Jimenez, medical director at Attune Med Spa in Connecticut, also emphasizes the need to be cautious with GLP-1 medications, stating that they can cause delayed gastric emptying (gastroparesis). This delay can lead to complications during surgery and affect post-operative recovery. He advises patients to review all their medications with both their surgeon and anesthesiologist prior to surgery.
What Patients Should Do Before Surgery
It’s crucial for patients to follow the instructions provided by their healthcare team before undergoing surgery. Depending on the type of GLP-1 agonist they use, patients may need to pause their medication for several days or even weeks before their procedure. The American Association of Nurse Anesthesiology has issued similar recommendations, supporting the need for careful management of these medications in perioperative patients.
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