Paggers Larissa, Mesotten Dieter, Stragier Hendrik
From the Department of Anaesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Genk (LP, DM, HS), Faculty of Medicine and Life Sciences, UHasselt, Diepenbeek (DM) and CARIM School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands (HS).
Eur J Anaesthesiol. 2025 Feb 1;42(2):140-151. doi: 10.1097/EJA.0000000000002103. Epub 2024 Nov 29.
With the growing use of glucagon-like-peptide-1 (GLP-1) receptor (GLP-1R) agonists as anti-obesity medication it is becoming increasingly important to examine its consequences in the peri-operative period. GLP-1R agonists are known for their effects of glucose-lowering and gastroparesis the latter causing some safety concerns regarding induction of anaesthesia, more specifically the risk of pulmonary aspiration. This article gathers the available evidence on this subject in addition to the already established guidelines. Current evidence makes us assume there is indeed an increased level of gastroparesis, but there are no studies to date with evidential confirmation of a presumed elevated risk of pulmonary aspiration. Future perspectives should focus on the actual risk of pulmonary aspiration and the possible implementation of ultrasound in the preoperative assessment.
随着胰高血糖素样肽-1(GLP-1)受体(GLP-1R)激动剂作为抗肥胖药物的使用越来越多,研究其在围手术期的影响变得越来越重要。GLP-1R激动剂以其降血糖和胃轻瘫作用而闻名,后者在麻醉诱导方面引起了一些安全问题,更具体地说是肺误吸的风险。本文除了已有的指南外,还收集了关于该主题的现有证据。目前的证据使我们认为胃轻瘫水平确实有所增加,但迄今为止尚无研究能确凿证实推测的肺误吸风险升高。未来的研究方向应聚焦于肺误吸的实际风险以及术前评估中超声检查的可能应用。