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A group of researchers looked at all the available medical studies to see how drugs called GLP-1-based therapies affect people having surgery. These drugs are the class that includes medicines like semaglutide (the active drug in Ozempic and Wegovy). The review pulled together previous studies to check whether taking these drugs around the time of an operation changes surgical outcomes or causes extra risks. GLP-1-based therapies are medicines that mimic a hormone your gut makes after you eat. That hormone helps reduce appetite, slows how fast your stomach empties, and helps control blood sugar. Doctors use these drugs for type 2 diabetes and, more recently, for weight loss. People take them as injections or pills, and they can change digestion and appetite in ways that matter when you go into surgery and anesthesia. The review summarized other studies rather than running a new experiment. That means it reports what’s already been observed across different hospitals and patient groups. The main concern is that these drugs slow stomach emptying, which could increase the chance that food or stomach acid is still in the stomach during anesthesia. That could raise the risk of aspiration (breathing stomach contents into the lungs), a dangerous complication. The review also looked at whether GLP-1 drugs affect blood sugar during surgery, wound healing, or rates of other complications. The evidence is mixed, and many of the studies were small or observational (they watched what happened instead of randomly assigning patients), so the findings aren’t definitive. For most patients, the practical point is that surgeons and anesthesiologists should know if someone is taking a GLP-1 drug before surgery. Some hospitals and professional groups are already advising clinicians to think about holding these medications for a short time before elective (planned) surgeries to lower the chance of stomach contents causing problems under anesthesia. This is mainly relevant for people having general anesthesia or procedures that affect breathing. It also matters for patients with diabetes, because stopping the drug could change blood-sugar control and needs monitoring. There are important caveats. The review highlights uncertainty because many studies were small, varied in how they were done, and didn’t always separate different GLP-1 drugs or patient types. Side effects of the drugs themselves — like nausea, vomiting, or low blood sugar when combined with other diabetes medicines — can complicate perioperative care. Also, abruptly stopping a diabetes drug can carry its own risks, so decisions should be individualized and made with your medical team. Regulatory bodies haven’t issued a universal rule, so practices differ between hospitals. Bottom line: GLP-1 drugs may affect stomach emptying and perioperative risk, so tell your surgical team if you’re taking one — they may recommend pausing it before certain procedures, but the best plan depends on your situation.
Source: Cureus