GLP-1 Agonists Before Orthopedic Surgery: What Does the Research Say?

GLP-1 receptor agonists (a class of drugs mimicking a natural hormone to regulate blood sugar and appetite) are increasingly prescribed for conditions like type 2 diabetes and obesity. As more patients on these medications undergo surgery, understanding their impact on surgical outcomes is critical. This scoping review addresses the specific knowledge gap regarding perioperative and recovery outcomes for patients using GLP-1 RAs before orthopedic surgery.

The review identified a limited but growing body of evidence on the topic. A consistent concern highlighted was the potential for delayed gastric emptying associated with GLP-1 RA use, which could theoretically increase the risk of pulmonary aspiration during anesthesia if not properly managed. However, the review found no consistent evidence suggesting a significant increase in major adverse cardiovascular events, surgical site infections, or other severe complications directly attributable to preoperative GLP-1 RA use across the studies. > The most critical finding was the urgent need for standardized perioperative management protocols, particularly regarding fasting guidelines, for patients on GLP-1 RAs. The synthesis also revealed considerable heterogeneity in study designs, patient populations, and outcome reporting, making direct comparisons and definitive conclusions challenging. Overall, while specific risks require careful consideration, the data did not indicate a widespread increase in severe adverse outcomes, but rather emphasized the importance of awareness and tailored management.