Amsterdam UMC Location University of Amsterdam, Department of Anaesthesiology, Amsterdam, The Netherlands; Amsterdam UMC Location University of Amsterdam, Department of Paediatric Intensive Care, Emma Children's Hospital, Amsterdam, The Netherlands.
Amsterdam UMC Location University of Amsterdam, Department of Endocrinology and Metabolism, Amsterdam, The Netherlands; Research Institute, Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, the Netherlands.
Br J Anaesth. 2024 Apr;132(4):644-648. doi: 10.1016/j.bja.2024.01.001. Epub 2024 Jan 29.
Prescriptions and use of glucagon-like peptide-1 (GLP-1) receptor agonists are increasing dramatically, as indications are expanding from the treatment of diabetes mellitus to weight loss for people with obesity. As GLP-1 receptor agonists delay gastric emptying, perioperative healthcare practitioners could be concerned about an increased risk for pulmonary aspiration during general anaesthesia. We summarise relevant medical literature and provide evidence-based recommendations for perioperative care for people taking GLP-1 receptor agonists. GLP-1 receptor agonists delay gastric emptying; however, ongoing treatment attenuates this effect. The risk of aspiration during general anaesthesia is unknown. However, we advise caution in patients who recently commenced on GLP-1 receptor agonists. After over 12 weeks of treatment, standard fasting times likely suffice to manage the risk of pulmonary aspiration for most otherwise low-risk patients.
胰高血糖素样肽-1（GLP-1）受体激动剂的处方和使用量正在大幅增加，因为其适应证正在从糖尿病治疗扩展到肥胖人群的体重减轻。由于 GLP-1 受体激动剂可延迟胃排空，因此围手术期医护人员可能会担心全身麻醉期间发生肺吸入的风险增加。我们总结了相关的医学文献，并为使用 GLP-1 受体激动剂的患者提供了围手术期护理的循证建议。GLP-1 受体激动剂可延迟胃排空；然而，持续治疗可减弱这种作用。全身麻醉期间发生吸入的风险尚不清楚。但是，我们建议最近开始使用 GLP-1 受体激动剂的患者要谨慎。治疗 12 周后，对于大多数低风险患者而言，标准禁食时间可能足以管理肺吸入的风险。
