Khak Mohammad, Adams Jeremiah A, Hozien Muhammad, Ilyas Asif M
Orthopaedic Surgery, Rothman Orthopaedic Institute, Philadelphia, USA.
Orthopedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, USA.
Cureus. 2025 Jul 31;17(7):e89183. doi: 10.7759/cureus.89183. eCollection 2025 Jul.
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed for glycemic control and weight loss, but their effects on surgical outcomes remain incompletely understood. Delayed gastric emptying and associated perioperative risks have prompted updated anesthetic guidelines, although evidence in orthopaedic or hand surgery remains limited. This study aims to evaluate the prevalence of GLP-1 RA use and its perioperative implications among patients undergoing surgical fixation for distal radius fractures (DRFs).
A retrospective review of 4,811 adult patients undergoing operative treatment for DRFs between 2019 and 2024 was conducted. GLP-1 RA use prior to surgery was identified through medication reconciliation. Demographics, comorbidities, medication type, and postoperative complications, including nausea, vomiting, abdominal pain, aspiration, emergency visits, and hospital readmissions, were assessed.
GLP-1 RA use was observed in 46 patients (1.0%) over a six-year period, with prevalence rising from 0.4% to 0.5% annually between 2019 and 2022 (three to four patients each year) to 1.0% in 2023 (eight out of 808 patients) and to 2.9% in 2024 (23 out of 781 patients). Semaglutide was the most commonly used agent in the cohort. Only one GLP-1 user (2.2%, one out of 46) experienced postoperative nausea. There were no cases of aspiration or serious complications documented.
GLP-1 RA use among orthopaedic trauma patients is increasing, reflecting broader prescribing trends. In this cohort, perioperative complications were rare, although underreporting may be a factor. The retrospective nature of the study and the relatively small number of GLP-1 users limit the generalizability of the findings. Nonetheless, orthopaedic surgeons should be aware of potential anesthetic considerations, evolving guidelines, and the importance of coordinated perioperative planning as GLP-1 use expands.
胰高血糖素样肽-1受体激动剂（GLP-1 RAs）越来越多地被用于控制血糖和减轻体重，但其对手术结局的影响仍未完全明确。胃排空延迟及相关围手术期风险促使麻醉指南更新，尽管骨科或手外科的相关证据仍然有限。本研究旨在评估接受桡骨远端骨折（DRF）手术固定的患者中GLP-1 RA的使用情况及其围手术期影响。
对2019年至2024年间接受DRF手术治疗的4811例成年患者进行回顾性研究。通过药物核对确定术前使用GLP-1 RA的情况。评估人口统计学、合并症、药物类型以及术后并发症，包括恶心、呕吐、腹痛、误吸、急诊就诊和再次入院情况。
在六年期间，46例患者（1.0%）使用了GLP-1 RA，其使用率从2019年至2022年期间每年从0.4%升至0.5%（每年3至4例患者），到2023年升至1.0%（808例患者中的8例），2024年升至2.9%（781例患者中的23例）。司美格鲁肽是该队列中最常用的药物。只有1例GLP-1使用者（占2.2%，46例中的1例）出现术后恶心。未记录到误吸或严重并发症病例。
骨科创伤患者中GLP-1 RA的使用正在增加，反映了更广泛的处方趋势。在该队列中，围手术期并发症很少见，尽管漏报可能是一个因素。本研究的回顾性性质以及GLP-1使用者相对较少限制了研究结果的普遍性。尽管如此，随着GLP-1使用范围扩大，骨科医生应意识到潜在的麻醉注意事项、不断演变的指南以及围手术期协调规划的重要性。
