GLP-1 Considerations in Surgery

Ozempic? Wegovy? Trulicity? Talk to your doctor before surgery.

GLP-1 "wonder drugs'' are becoming incredibly popular for their use in weight loss, appetite suppression, and diabetes management. Recently, we’ve learned that part of what makes this class of medicines so great (feeling “full” after not eating a lot) can also make anesthesia dangerous.

The stomach has strong muscles that help churn and break down what you eat before passing it down into your intestines. This process is slowed down with GLP-1 agonists, keeping last night’s carne asada tacos in your stomach longer, potentially even until the next day. This is not usually a problem… except when the next day is surgery.

When you undergo general anesthesia and become totally unconscious, besides appearing “asleep,” your muscles also relax involuntarily. This includes the muscles in your stomach and esophagus! Old food could slip back up from the stomach and go down your windpipe into the lungs. This is called aspiration, and the bacteria from food going into your airways can lead to pneumonia or even death.

The American Society of Anesthesiologists recommends skipping your dose on the day of surgery if you take it daily, and skipping your weekly dose before surgery if you take it weekly.1 If your reason for taking GLP-1 agonist is weight-loss, you shouldn’t need to do anything else. If you take the medicine for diabetes, your endocrinologist or primary care physician will need to give you additional strategies to prevent high blood sugar while off this medicine. This last step is incredibly important and often forgotten.

Tell your surgeon that you take Ozempic! Surgery should be scheduled appropriately so you can plan for skipping a dose.

Tell your pre-op nurse who calls the day before surgery that you take Wegovy! If you are nauseated from recently starting it, your surgery may need to be rescheduled.

Tell your anesthesiologist that you take Trulicity! Precautions can be taken to reduce the risk of aspiration if surgery must proceed after a recent dose.

With new medicines being developed nearly every day, standard hospital protocols and policies may not appropriately address the medications you take.  With this knowledge about your GLP-1 agonist, you have the ‘map’ to advocate for yourself to get the right care!

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