New Guidance Suggests Most Patients Can Continue GLP-1 Medications Before Surgery

In new guidelines, the American Society of Anesthesiologists (ASA) and other professional groups recommend that most patients using glucagon-like peptide-1 (GLP-1) receptor agonists can continue their medication regimen prior to elective surgery. While these drugs, including Ozempic and Wegovy, are popular for managing diabetes, weight loss, and cardiovascular conditions, they carry risks of delayed gastric emptying, which can complicate anesthesia. The guidance highlights strategies to mitigate these risks, including adjusting preoperative diets and using ultrasound to assess stomach contents before surgery.

What’s New?

The clinical recommendations address a common dilemma in perioperative care: whether patients on GLP-1 drugs should pause medication before surgery to reduce the risk of regurgitation and aspiration. Such risks arise due to the delayed gastric emptying effects of GLP-1 medications, which can leave residual food in the stomach, increasing the potential for aspiration pneumonia. For patients at high risk of gastrointestinal (GI) side effects, the guidance advises a liquid-only diet 24 hours before surgery and tailored anesthesia plans. The use of ultrasound to evaluate stomach contents just before surgery is also recommended, particularly for those with severe symptoms. Importantly, most patients can safely continue their GLP-1 therapy without interruption, except in cases of pronounced GI side effects or other risk factors.

Why It Matters

As approximately 12% of U.S. adults use GLP-1 drugs, these guidelines aim to provide clarity for perioperative management, reducing unnecessary medication interruptions while prioritizing patient safety. Adjusting GLP-1 drug usage around surgical procedures can impact blood glucose control and complicate treatment for patients with diabetes. For anesthesiologists and surgical teams, this guidance helps balance the benefits of continued GLP-1 use against potential surgical risks, ensuring patient-specific care. By tailoring preoperative plans based on individual risk factors, healthcare teams can facilitate safer surgical outcomes for patients on GLP-1 medications, supporting both effective anesthetic management and continuity of treatment.