A group of doctors has advised that individuals using diabetes and weight loss drugs like Novo Nordisk’s Ozempic and Wegovy should discontinue their use prior to elective surgery in order to reduce the potential for serious health complications. The American Society of Anesthesiologists (ASA), an organization comprised of over 53,000 anesthesiology physicians, released interim guidance stating this recommendation.
These guidelines were designed to assist doctors in managing patients who are scheduled to undergo elective surgeries, such as joint replacements, kidney stone removal, and cosmetic procedures. They are intended to address concerns regarding delayed stomach emptying, a common side effect of diabetes and weight loss drugs that mimic the gut hormone GLP-1, leading to appetite suppression.
The ASA has received anecdotal reports across the United States suggesting that patients taking these drugs during general anesthesia and deep sedation may be at a higher risk of experiencing severe complications, such as nausea, vomiting, and aspiration, which occurs when food is accidentally inhaled into the lungs instead of being swallowed.
Prior to undergoing anesthesia, patients are typically required to fast to prevent stomach contents from entering the lungs. However, despite the association of Ozempic and Wegovy with side effects like diarrhea and constipation, the exact interaction between anesthesia and these GLP-1 drugs remains largely unknown due to the lack of scientific data.
Approximately 60,000 individuals receive general anesthesia each day in the United States, but the daily usage of GLP-1 drugs is unknown. These drugs have recently gained popularity for their perceived effectiveness in weight loss, resulting in shortages of Novo Nordisk’s Ozempic and Wegovy and increased competition from similar treatments like Eli Lilly’s Mounjaro.
According to the ASA’s guidance, patients taking GLP-1 drugs on a daily basis should abstain from treatment on the day of their elective surgery, while those using them weekly should discontinue treatment for a week prior to the procedure. Doctors are advised to consult with an endocrinologist for guidance on diabetes patients taking GLP-1 drugs before surgery. Additionally, if a patient experiences nausea, vomiting, abdominal bloating, or pain on the day of their scheduled procedure, doctors should consider postponing the surgery. If symptoms are absent but the patient did not stop using GLP-1 drugs prior to surgery, doctors should use ultrasound to determine if the patient’s stomach is full.
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