GLP-1 drugs linked to 11-fold higher regurgitation rate under anesthesia

A study presented at the Association of Anaesthetists Annual Meeting in Liverpool has found that patients taking glucagon-like peptide-1 receptor agonist (GLP-1 RA) drugs, commonly used for diabetes and obesity treatment, are 11 times more likely to experience complications such as regurgitation of stomach contents during anesthesia compared to those not taking these medications.

The research, led by Dr. Kariem El-Boghdadly and colleagues, analyzed data from 47,039 UK patients undergoing surgical procedures under an anesthetist's care. While the absolute risk remains low, the increased likelihood is concerning given that many patients (over 40%) obtain GLP-1 RAs through online pharmacies, bypassing traditional prescribing routes.

This class of drugs can cause delayed gastric emptying, potentially leading to pulmonary aspiration if patients are not given enough time to empty their stomachs before surgery. The study highlights significant variability in perioperative management of GLP-1 RA use, with nearly a third of patients advised to stop their medication preoperatively, often for just 8-14 days, which may not be sufficient given the half-lives of these drugs (5-7 days).

The discrepancy between guidelines recommending continued use of GLP-1 RAs during the perioperative period and clinical practice raises questions about the appropriate duration of medication cessation to reduce the risk of these complications.