Guidance Issued for Safe Use of GLP-1 RAs in the Perioperative Period

TUESDAY, Nov. 5, 2024 (HealthDay News) — In a multisociety clinical practice guidance document, published online Oct. 29 in Surgery for Obesity and Related Diseases, recommendations are presented for the safe use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in the perioperative period.

Noting that GLP-1 RAs have revolutionized the care of patients with metabolic disease, Tammy L. Kindel, M.D., Ph.D., from the Medical College of Wisconsin in Milwaukee, and colleagues developed recommendations for the safe use of GLP-1 RAs in the perioperative period.

The authors recommend that GLP-1 RA use in the perioperative period should be based on shared decision-making of the patient with procedural, anesthesia, and prescribing care teams, focusing on balancing the metabolic need for GLP-1 RAs with patient risk. Variables that elevate the risk for delayed gastric emptying and aspiration should be considered, with their assessment occurring with enough time before surgery to allow for adjustments in perioperative care, if needed. Safe GLP-1 RA use should include efforts to minimize the aspiration risk of delayed gastric emptying, which can be achieved by preoperative diet modification and/or altering anesthesia. In cases with concern for delayed gastric emptying, preoperative diet modification (a preoperative liquid diet for at least 24 hours) can be utilized.

“This multisociety clinical practice document should be considered guidance and not an evidence-based guideline, focusing on shared decision-making and balancing safety processes with therapeutic metabolic need for the safe continuation of surgical and procedural care in patients taking GLP-1 RAs,” the authors write.

Several authors disclosed ties to the pharmaceutical and medical device industries.

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