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在深度镇静或全身麻醉前使用胰高血糖素样肽-1受体激动剂的叙述性综述。

A narrative review of glucagon-like peptide-1 receptor agonists prior to deep sedation or general anesthesia.

作者信息

Vetrugno Luigi, Deana Cristian, Da Porto Andrea, Boero Enrico, Bellini Valentina, Biasucci Daniele Guerino, Bignami Elena Giovanna

机构信息

Department of Emergency, Health Integrated Agency of Friuli Centrale, Tolmezzo, Italy.

Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy.

出版信息

J Anesth Analg Crit Care. 2025 Mar 28;5(1):16. doi: 10.1186/s44158-025-00237-y.

Abstract

Glucagon-like peptide-1 receptor agonists are a class of drugs that mimic a natural incretin hormone released by the intestine after meals, and they are well-suited for treating type 2 diabetes. Glucagon-like peptide-1 receptor agonists also lead to satiety and appetite reduction through action on the brain's appetite regulation centers, leading to weight loss in obese patients. However, because glucagon-like peptide-1 receptor agonists work to slow gastric emptying, a safety concern has been raised in patients undergoing deep sedation or general anesthesia regarding gastric aspiration, and considering their long half-life in the blood, they are difficult to manage in the perioperative period. The purpose of this review is (i) to explore the present knowledge about the risk of aspiration before anesthesia; (ii) to describe the method for evaluating the presence of liquid and food in the stomach before surgery; and (iii) to balance the actual warning with the opportunity for future discovery about their benefits.

摘要

胰高血糖素样肽-1受体激动剂是一类模仿餐后肠道释放的天然肠促胰岛素激素的药物,非常适合治疗2型糖尿病。胰高血糖素样肽-1受体激动剂还通过作用于大脑的食欲调节中枢导致饱腹感和食欲降低,从而使肥胖患者体重减轻。然而,由于胰高血糖素样肽-1受体激动剂会减缓胃排空,对于接受深度镇静或全身麻醉的患者,胃内容物误吸的安全性问题已被提出,并且考虑到它们在血液中的半衰期较长,在围手术期难以管理。本综述的目的是:(i)探讨目前关于麻醉前误吸风险的知识;(ii)描述术前评估胃内液体和食物存在情况的方法;(iii)在实际警示与未来发现其益处的机会之间取得平衡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc93/11951578/9e5e99bf0af8/44158_2025_237_Fig1_HTML.jpg

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