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替尔泊肽治疗阻塞性睡眠呼吸暂停:一种新的治疗前景及围手术期注意事项

Tirzepatide for Obstructive Sleep Apnea: A Novel Therapeutic Promise and the Perioperative Considerations.

作者信息

Kukanti Chandini, Chowdhury Sumit Roy, Singh Gyaninder Pal

机构信息

Department of Neuroanesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, 110029 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2025 Jun;77(6):2430-2432. doi: 10.1007/s12070-025-05485-6. Epub 2025 Apr 28.

Abstract

Obstructive sleep apnea (OSA) is a prevalent global health issue, with recent advances in pharmacotherapy expanding treatment options. Tirzepatide, a dual GLP-1 and GIP receptor agonist, has been newly approved by the FDA for managing moderate to severe OSA, following promising results from major randomized trials. Initially indicated for type 2 diabetes mellitus, Tirzepatide promotes glycemic control and weight loss through incretin-mediated insulin secretion and appetite suppression. As its use becomes more widespread, perioperative physicians and head-neck surgeons must be familiar with its pharmacokinetics and associated risks. Notably, delayed gastric emptying, a dose-dependent side effect, raises concerns of pulmonary aspiration during general anesthesia. Preoperative gastric ultrasound, diet modification, and individualized glycemic management are recommended strategies. Given the limited high-quality data, a multidisciplinary, institution-specific approach remains essential in managing patients on Tirzepatide in the perioperative setting.

摘要

阻塞性睡眠呼吸暂停(OSA)是一个普遍存在的全球健康问题,药物治疗的最新进展扩大了治疗选择。替尔泊肽是一种双重GLP-1和GIP受体激动剂,在主要随机试验取得有前景的结果后,已被美国食品药品监督管理局(FDA)新批准用于治疗中度至重度OSA。替尔泊肽最初用于2型糖尿病,通过肠促胰岛素介导的胰岛素分泌和食欲抑制来促进血糖控制和体重减轻。随着其使用越来越广泛,围手术期医生和头颈外科医生必须熟悉其药代动力学及相关风险。值得注意的是,胃排空延迟是一种剂量依赖性副作用,这引发了对全身麻醉期间肺误吸的担忧。术前胃超声检查、饮食调整和个体化血糖管理是推荐的策略。鉴于高质量数据有限,在围手术期管理接受替尔泊肽治疗的患者时,多学科、针对机构的方法仍然至关重要。

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