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Published: Monday, 23 October 2023 13:29

Written by 340B Editor

In recent years, the consideration of GLP-1 agonists' impact on gastric emptying has gained prominence in the field of anesthesiology.

Evidence and case studies have shown that patients using these medications can retain stomach contents even after a standard fasting period, raising concerns about their vulnerability to vomiting and aspiration during anesthesia. However, the available data is limited, making it challenging to draw concrete conclusions on how to adjust GLP-1 agonist dosing and fasting protocols. To address this issue, the American Society of Anesthesiologists has released updated recommendations, which we will summarize in this article.

Summary of Recommendations:

For patients scheduled for elective procedures, it's important to consider the following recommendations for the days leading up to the procedure:

1. **Daily Dosing**:
- If a patient is on daily dosing of GLP-1 agonists, it is advisable to **temporarily discontinue** their use on the day of the procedure or surgery.

2. **Weekly Dosing**:
- For patients receiving GLP-1 agonists on a weekly basis, it is recommended to **pause** the medication for a week before the scheduled procedure or surgery.

These suggestions are **independent of the patient's medical condition** (whether for type 2 diabetes mellitus or weight loss), the dosage of the GLP-1 agonist, or the type of procedure or surgery they are undergoing.

However, it is essential to note that if GLP-1 agonists prescribed for diabetes management are withheld for a duration longer than their standard dosing schedule, it is strongly advised to **consult an endocrinologist**. This consultation is necessary to establish a plan for bridging the antidiabetic therapy effectively, ensuring that patients do not experience hyperglycemia during the fasting period.

For detailed information and the most up-to-date recommendations on the preoperative management of patients on GLP-1 receptor agonists, please refer to the [American Society of Anesthesiologists' Consensus-Based Guidance](https://www.asahq.org/) for a comprehensive understanding of their latest guidelines.

In conclusion, while the interactions between GLP-1 agonists and preoperative fasting require further research, these recommendations offer practical guidance for healthcare professionals in managing patients on GLP-1 agonists before elective procedures, prioritizing patient safety during the perioperative period.

By:

Sara Jones, Pharm D.

Consulting Pharmacist

Northwest Human Services