P.Patients fast before surgery to prevent food from entering the lungs during surgery, a serious concern that can lead to lung infections. However, fasting alone may not be enough to ensure hunger for those undergoing treatments such as Ozempic and Wegobee, which are widespread.
Published by the American College of Anesthesiologists guidance On Thursday, he advised patients to stop taking this class of drugs, called GLP-1 drugs, before undergoing surgery.
There are limited data on how these agents affect people undergoing surgery, but based on anecdotal reports, the delayed gastric emptying caused by these agents can cause patients to become under anesthesia. There are concerns that there may be an increased risk of regurgitation and aspiration of food into the lungs when the patient is in bed, the researchers said. Said.
GLP-1 drugs for type 2 diabetes and obesity have exploded in popularity due to their ability to significantly reduce weight. They mimic the effects of the glucagon-like peptide 1 hormone, which aids in postprandial satiety. Treatments such as Novo Nordisk’s Ozempic and Wegoby and Eli Lilly’s Munjaro have gastrointestinal side effects such as nausea, vomiting and delayed gastric emptying.
Michael Champeau, president of the Anesthesiologists Group, said when doctors performed endoscopies on patients taking these drugs, they could see food in their stomachs. He said he had heard anecdotes about patients vomiting food before surgery and patients under anesthesia. And food came out during the operation.
Normally, the group reviews extensive literature before issuing formal guidelines, but in this case there was little research, he said. “So many people were concerned about this issue that we wanted to provide some guidance.”
The group’s statement noted that there were reports that long-term use of the drug diminished its gastric emptying effect, but Champeau said it was not clear how long patients would need to take the drug to improve their stomach contents. He said he didn’t have enough data yet to determine. dangerous.
“The relationship between how long the drug is taken and how much stomach content remains is currently not very predictable, so we don’t want to jeopardize the patient’s health,” he said.
The delayed stomach emptying of GLP-1 drugs can also affect how well patients absorb other oral medications they take.of label Lily’s Munjaro recommends that patients taking oral contraceptives switch to parenteral contraceptives or add an additional method of contraception with each dose increase after starting the drug. is recommended. According to the label, studies have shown that the drug’s effect on gastric emptying is greatest after the first dose and decreases after subsequent doses.
For patients undergoing emergency surgery, doctors should assume the patient is full and take precautions, the group of anesthesiologists said.
For elective treatment, the research group recommends that patients taking daily GLP-1 drugs stop treatment on the day of surgery, and weekly patients stop treatment one week before surgery.
The group also said doctors should consider postponing surgery if patients experience gastrointestinal symptoms such as severe nausea and vomiting, abdominal pain and bloating.some data suggestion The presence of gastrointestinal side effects is related to how much food is in the stomach.
If patients have no gastrointestinal symptoms but are not receiving GLP-1 drugs, doctors should consider using ultrasound to assess stomach contents, the researchers said. If the stomach is empty, the doctor can proceed with treatment as usual, but if the stomach is full or the ultrasound is inconclusive, the doctor may delay the procedure or take precautions when full. should consider adding
The group says anesthesiologists should also discuss the risks of reflux and food aspiration with other doctors and patients involved in the procedure.
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