| Title |
GLP-1 receptorių agonistų vartojimas ir aspiracijos rizika bendrosios anestezijos metu: patofiziologinių mechanizmų ir klinikinių rekomendacijų analizė |
| Translation of Title |
Use of GLP-1 receptor agonists and the risk of aspiration during general anesthesia: an analysis of pathophysiological mechanisms and clinical recommendations. |
| Authors |
Vyšniauskaitė, Gabrielė Marija ; Vrublevski, Marcin |
| DOI |
10.53453/ms.2026.5.2 |
| Full Text |
|
| Is Part of |
Medicinos mokslai = Journal of medical science.. Kėdainiai : VšĮ Lietuvos sveikatos mokslinių tyrimų centras. 2026, vol. 14, iss. 3, p. 9-18.. eISSN 2345-0592 |
| Keywords [eng] |
GLP-1 receptor agonists ; semaglutide ; tirzepatide ; gastric emptying ; pulmonary aspiration ; general anesthesia ; perioperative management ; gastric ultrasound |
| Abstract [eng] |
Introduction. Glucagon-like peptide-1 receptor agonists are widely used in the treatment of type 2 diabetes and obesity. With their increasing use, a growing number of surgical patients are receiving these medications. One of the main pharmacodynamic effects of this drug class is delayed gastric emptying, which may increase residual gastric volume and potentially elevate the risk of pulmonary aspiration during general anesthesia. Recent case reports and evolving professional recommendations have raised concerns regarding optimal perioperative management. Aim. To present the pharmacological and pathophysiological mechanisms associated with GLP-1 receptor agonists, evaluate clinical evidence regarding aspiration risk, and review perioperative management strategies. Methods. A literature review was conducted using the PubMed database. Randomized controlled trials, pharmacodynamic studies, cohort and retrospective analyses, systematic reviews, meta-analyses, and international guidelines were included. The selection strategy aimed to ensure that at least 70% of references were published after the year 2000. Keywords included GLP-1 receptor agonists, semaglutide, tirzepatide, gastric emptying, pulmonary aspiration, anesthesia, perioperative management, and gastric ultrasound. In total, 37 sources were analyzed. Results. GLP-1 receptor agonists significantly delay gastric emptying, particularly during treatment initiation and dose escalation. Several studies report increased residual gastric content despite adherence to standard fasting guidelines. Although aspiration events remain rare and are mainly described in case reports, emerging evidence has led to risk-stratified perioperative recommendations. Gastric ultrasound may assist in selected patients. Conclusions. GLP-1 receptor agonists may modify aspiration risk in certain clinical situations. Individualized perioperative assessment and appropriate airway protection strategies are recommended until stronger prospective evidence becomes available. |
| Published |
Kėdainiai : VšĮ Lietuvos sveikatos mokslinių tyrimų centras |
| Type |
Journal article |
| Language |
Lithuanian |
| Publication date |
2026 |
| CC license |
|
