{"id":7535,"date":"2025-06-25T17:30:48","date_gmt":"2025-06-25T14:30:48","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=7535"},"modified":"2025-06-25T17:30:48","modified_gmt":"2025-06-25T14:30:48","slug":"summary-new-perioperative-recommendations-for-glp-1-ra-users","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/summary-new-perioperative-recommendations-for-glp-1-ra-users\/","title":{"rendered":"Summary: New Perioperative Recommendations for GLP-1 RA Users"},"content":{"rendered":"<p>Summary:<br \/>\nNew Perioperative Recommendations for GLP-1 RA Users<br \/>\nSource: Medscape June 5 \/ British Journal of Anaesthesia, June 2025 .<br \/>\n1. Key Update:<br \/>\n\u2022 Patients on GLP-1 receptor agonists (GLP-1 RAs) should continue their medication before anesthesia but fast from solid foods for 24 hours to reduce aspiration risk.<br \/>\n2. Rationale:<br \/>\n\u2022 GLP-1 RAs delay gastric emptying, which may increase residual stomach content despite standard 8-hour fasting.<br \/>\n\u2022 Extended fasting time helps mitigate aspiration risk while preserving the benefits of GLP-1 RAs (e.g., glycemic control).<br \/>\n3. Background:<br \/>\n\u2022 2023 ASA guidelines suggested holding GLP-1s for one half-life and following standard 8-hour fasting.<br \/>\n\u2022 New evidence shows delayed gastric emptying may persist beyond one half-life, especially with long-acting agents like semaglutide and tirzepatide.<br \/>\n4. Updated Consensus (2025):<br \/>\n\u2022 Continue GLP-1 RAs in patients without significant GI symptoms.<br \/>\n\u2022 Solid food fasting: 24 hours before anesthesia.<br \/>\n\u2022 Clear liquids only allowed during fasting period.<br \/>\n\u2022 No liquids at all within 4 hours of procedure.<br \/>\n\u2022 Avoid high-glucose clear liquids (&gt;10% glucose) in the last 8 hours pre-op.<br \/>\n5. Patients at Higher Risk:<br \/>\n\u2022 Those in dose escalation phase, on weekly or high doses, or with GI symptoms (nausea, vomiting, bloating).<br \/>\n\u2022 Should adhere strictly to 24-hour liquid diet and be evaluated individually.<br \/>\n6. Postponing Procedures:<br \/>\n\u2022 Elective procedures should be delayed if patients exhibit severe GI symptoms.<br \/>\n\u2022 Physicians should assess and modify treatment or diet in such cases.<br \/>\n7. Criticism and Debate:<br \/>\n\u2022 Some experts argue there\u2019s insufficient evidence to stratify patients by dose or phase.<br \/>\n\u2022 Absence of GI symptoms doesn\u2019t guarantee an empty stomach.<br \/>\n8. Basis of Recommendation:<br \/>\n\u2022 Derived from a systematic review of 112 studies and a modified Delphi consensus process.<br \/>\n\u2022 Endorsed by: Society for Perioperative Assessment and Quality Improvement &amp; American Association of Clinical Endocrinology.<br \/>\n9. Clinical Implication:<br \/>\n\u2022 Aims to balance safety and continuity of care, especially in diabetic patients where stopping GLP-1s may worsen outcomes or trigger side effects on reinitiation.<br \/>\n<a href=\"https:\/\/click.mail.medscape.com\/?qs=e8406334fce7b9bcf86521f5afb571040f964e65dd8080c3a73ca2996c5e2746a72b0ced776c1ba25a84426d0fdc560f28eba418b38beaef146e94fa81921ef6\">https:\/\/click.mail.medscape.com\/?qs=e8406334fce7b9bcf86521f5afb571040f964e65dd8080c3a73ca2996c5e2746a72b0ced776c1ba25a84426d0fdc560f28eba418b38beaef146e94fa81921ef6<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Summary: New Perioperative Recommendations for GLP-1 RA Users Source: Medscape June 5 \/ British Journal of Anaesthesia, June 2025 . 1. Key Update: \u2022 Patients on GLP-1 receptor agonists (GLP-1 RAs) should continue their medication before anesthesia but fast from solid foods for 24 hours to reduce aspiration risk. 2. Rationale: \u2022 GLP-1 RAs delay [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-7535","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/7535","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=7535"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/7535\/revisions"}],"predecessor-version":[{"id":7541,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/7535\/revisions\/7541"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=7535"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=7535"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=7535"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}