Am J Gastroenterol
Do GLP-1 agonists need to be stopped before surgery?
Although GLP-1 receptor agonists were found to delay gastric emptying by roughly 36 minutes, the difference was deemed of limited magnitude relative to standard periprocedural fasting periods. For liquid emptying specifically, no substantial differences in gastric emptying were detected (by acetaminophen absorption test), particularly at time points relevant to standard periprocedural care.
Fifteen studies met inclusion criteria for this systematic review and meta-analysis. Five studies (n = 247) utilized gastric emptying scintigraphy. Mean T 1/2 was 138.4 min for GLP-1 RA vs. 95.0 min for placebo (pooled mean difference, 36.0 min). Ten studies (n = 411) utilized the acetaminophen absorption test, with no significant delay in gastric emptying measured by Tmax, AUC 4hr, and AUC 5hr with GLP-1 RA. Gastric emptying wasn’t impacted by type of GLP-1 RA, mechanism of action, or treatment duration.
Based on the findings, authors recommend the following for periprocedural care of patients taking GLP-1 agonists:
- Continue GLP-1 agonist
- Liquid diet on day prior to procedure
- Standard pre-anesthesia fasting period
Source:
Hiramoto B, et al. (2024, June 1). Am J Gastroenterol. Quantified Metrics of Gastric Emptying Delay by Glucagon-Like Peptide-1 Agonists: A Systematic Review and Meta-Analysis With Insights for Periprocedural Management. https://pubmed.ncbi.nlm.nih.gov/38634551/