The American Association of Nurse Anesthesiology (AANA) has published a document concerning special anesthetic care of patients on glucagon-like peptide-1 (GLP-1) agonists.

GLP-1 agonists, like Ozempic / Wegovy and Saxenda, “have become increasingly popular in promoting weight loss.” The medications were initially designed to “manage type 2 diabetes,” and they “bind and activate receptors located throughout the body, eliciting a biological response similar to naturally occurring GLP-1, a gut-derived hormone usually released after eating fats and carbohydrates. Patients feel full sooner and tend to eat less.”

These medications also “slow gastric emptying.” This is crucial because “clinical guidelines call for a patient to fast prior to anesthesia because food remaining in a patient’s stomach can cause serious complications such as vomiting and food aspiration.” This necessitates additional preparation for patients on these medications, given that their stomachs empty slower.

As a result of these risks, “providers may need to do additional screenings such as a point-of-care ultrasound of a patient’s stomach contents before surgery. If the ultrasound indicates that gastric contents are present or imaging is inconclusive, the surgical team may consider delaying an elective procedure or proceeding as ‘full stomach’ to mitigate the risks of regurgitation and aspiration while intubated for anesthesia care.” Example recommendations laid out in these considerations for care include “if daily dose [of GLP-1 agonist]: consider holding day of surgery/procedure” and “if weekly dose: consider holding one week before surgery/procedure.”

The AANA’s website has the release.