Review outlines perioperative considerations for patients on GLP-1R agonists undergoing surgery

Glucagon-like peptide-1 receptor (GLP-1R) agonists are increasingly prescribed for type 2 diabetes mellitus and obesity, offering significant metabolic benefits. However, these medications are known to induce gastrointestinal adverse effects, notably delayed gastric emptying. This physiological change poses a unique challenge in the perioperative setting, as it can increase the risk of aspiration during anesthesia and impact the timing of medication administration. Current standard-of-care protocols often lack specific guidance for managing patients on GLP-1R agonists around surgical procedures, creating a critical gap in patient safety and clinical practice.

This review article synthesizes historical insights into the discovery and development of GLP-1R agonists, detailing their mechanism of action and current market availability. It provides an overview of FDA-approved GLP-1R agonists, comparing their effects on weight loss and discussing their role in the context of bariatric surgery. The core of the article focuses on reviewing perioperative considerations for surgical patients using GLP-1R agonists, culminating in suggested recommendations for clinical practice to mitigate surgical risks.

The review highlights that GLP-1R agonists significantly impact gastrointestinal function, primarily causing delayed gastric emptying, which is a critical concern for patients undergoing surgery due to increased aspiration risk. It details the mechanism of action of these drugs and their influence on various gastrointestinal adverse effects including nausea, constipation, and altered bowel habits.

Specific perioperative recommendations are provided to manage these risks, ensuring patient safety during surgical procedures by addressing the unique physiological changes induced by GLP-1R agonists. The article also compares the weight loss efficacy among available GLP-1R agonists and discusses their utility in bariatric surgery contexts, emphasizing the need for individualized patient assessment and management protocols to optimize outcomes and minimize complications.