Guy’s and St Thomas’ NHS Foundation Trust and King’s College London researchers found GLP-1 receptor agonist drugs are linked to an 11-fold higher rate of regurgitation and pulmonary aspiration during anesthesia, according to a nationwide UK cohort study presented at the Association of Anaesthetists Annual Meeting in Liverpool, England, Sept. 16-18.
Dr. Kariem El-Boghdadly led the study on behalf of the GLIMPSE Resident Research Networks and Collaborators. The team tracked 47,039 adults undergoing elective or emergency procedures under anesthetist care at 119 UK sites, screening each for GLP-1 drug use — including semaglutide and tirzepatide — in the three months before their procedure.
Of the 1,348 patients (2.9%) who reported taking a GLP-1 drug, 19 experienced pulmonary aspiration or regurgitation, a rate of 1 in 71. Among patients not taking the drugs, the rate was 1 in 802. More than 40% of GLP-1 users obtained the medication outside GP or hospital prescriptions, most often for weight management, and complications occurred most frequently as patients woke from anesthesia.
Nearly a third of patients stopped their GLP-1 medication before surgery on medical advice, typically for eight to 14 days. The Association of Anaesthetists’ guidance instead recommends continuing the drugs throughout the perioperative period, since stopping for less than three to four weeks may not clear the drugs’ effect on the stomach. “These data are not generalizable, but highlight the importance of patients taking GLP-1 RAs informing their anesthetists about this, regardless of where they get them,” the study authors wrote.
The authors cautioned that causality remains unproven, since obesity and diabetes — both independent aspiration risk factors — are overrepresented among GLP-1 users in the cohort. The findings, published in the journal Anaesthesia, arrive as GLP-1 prescriptions surge across the UK and other developed nations for diabetes and obesity treatment.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
