By Amber Roman
06 Aug 2024, 13:36 PM EDT
A recent study led by UTHealth Houston has revealed that patients taking GLP-1 medications, such as Ozempic, Wegovy and Mounjaro, may face significant complications during surgical procedures.
These medications, commonly prescribed for type 2 diabetes and obesity, slow digestion, causing food to remain in the stomach longer, even after following preoperative fasting protocols. This situation can lead to a potentially life-threatening condition known as pulmonary aspiration, in which food or liquid is inhaled into the lungs during surgery.
The study, published on the university’s website, found that more than half of patients taking GLP-1 receptor agonists had “significant gastric contents” before surgery.
Dr. Alfred Bonati, founder of the Bonati Spine Institute in Florida, explained that general anesthesia can cause nausea and that the slow digestion exacerbated by these medications increases the risk of vomiting during surgery, which in turn can cause pulmonary aspiration. This condition can result in severe lung damage, infections and even death.
Dr. Brett Osborn, a neurosurgeon and section chief at St. Mary’s Medical Center in Florida, recommends that his patients stop taking GLP-1 agonists at least a week before any surgical procedure. In addition to pulmonary aspiration, Osborn warned of the increased risk of postoperative ileus, a bowel dysfunction that can occur after surgery and predispose patients to problems such as intestinal ischemia, a rare condition in which blood flow to the intestines is reduced. Osborn also noted that postoperative healing may be compromised in patients taking these medications, as a low-calorie diet, common among these patients, can inhibit the recovery needed for surgery, which requires a caloric surplus and adequate protein intake.
Dr. Jean-Carlos Jimenez, medical director of Attune Med Spa in Connecticut, agreed that GLP-1 agonists can cause complications during surgery. These medications can cause nausea, vomiting and gastroparesis, a condition in which the stomach takes longer than normal to empty its contents into the small intestine, thereby increasing the risk of pulmonary aspiration during anesthesia and making postoperative recovery more difficult. Jimenez also noted that surgery can alter blood sugar levels due to the stress of the procedure, adding another layer of complexity for patients taking GLP-1.
Doctors agree that it is crucial for patients to review all medications they are taking with their surgeon and anesthesiologist before undergoing surgery. For procedures that require fasting or a clear liquid diet, patients may need to follow these instructions for a longer period of time. The timing of discontinuing GLP-1 treatment varies depending on the type of agonist used and the type of surgery. Generally, medications can be restarted at the next scheduled dose, but under close medical supervision.
The American Society of Anesthesiologists issued an announcement in June 2023 warning of these risks and recommending that patients consider pausing their GLP-1 doses in the days or weeks leading up to an elective surgical procedure. This precaution is essential to minimize risks and ensure a safe and effective recovery. Following the instructions provided by healthcare providers is critical, as these recommendations are tailored to each patient’s individual health needs and the specifics of their surgery.
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