Perioperative management of patients on glucagon-like peptide-1 receptor agonists.
Curr Opin Anaesthesiol
; 37(3): 323-333, 2024 Jun 01.
Article
em En
| MEDLINE
| ID: mdl-38390914
ABSTRACT
PURPOSE OF REVIEW To summarize the mechanism of action, clinical outcomes, and perioperative implications of glucagon-like peptide-1 receptor agonists (GLP-1-RAs). Specifically, this review focuses on the available literature surrounding complications (primarily, bronchoaspiration) and current recommendations, as well as knowledge gaps and future research directions on the perioperative management of GLP-1-RAs. RECENT FINDINGS:
GLP-1-RAs are known to delay gastric emptying. Accordingly, recent case reports and retrospective observational studies, while anecdotal, suggest that the perioperative use of GLP-1-RAs may increase the risk of bronchoaspiration despite fasting intervals that comply with (and often exceed) current guidelines. As a result, guidelines and safety bulletins have been published by several Anesthesiology Societies.SUMMARY:
While rapidly emerging evidence suggests that perioperative GLP-1-RAs use is associated with delayed gastric emptying and increased risk of bronchoaspiration (particularly in patients undergoing general anesthesia and/or deep sedation), high-quality studies are needed to provide definitive answers with respect to the safety and duration of preoperative drug cessation, and optimal fasting intervals according to the specific GLP-1-RA agent, the dose/duration of administration, and patient-specific factors. Meanwhile, clinicians must be aware of the potential risks associated with the perioperative use of GLP-1-RAs and follow the recommendations put forth by their respective Anesthesiology Societies.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Assistência Perioperatória
/
Esvaziamento Gástrico
/
Agonistas do Receptor do Peptídeo 1 Semelhante ao Glucagon
Limite:
Humans
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article