On This Episode:
Terry and Garry dive into the fascinating world of GLP-1 receptor agonists, those tiny molecules that can be both a blessing and a potential risk factor when it comes to anesthesia. In this episode, we’re going embark on a journey through the world of diabetes management, how it intersects with the realm of anesthesia and what the implications are for providers in the operating room.
And in the perioperative period, we’re going to shine a spotlight on these new agents, explore their effects, and we’re going to discuss the challenges they present to our CRNA colleagues.
So stay with us as we navigate through the complexities of these medications and their implications for anesthesia practice. It’s a critical topic today. And we’re here to provide insights, understanding, and perhaps a little comedy.
Here’s some of what we discuss in this episode:
- How SGLT2 inhibitors help with diabetes management.
- The basics of the GLP-1 receptor agonists.
- Examples of GLP-1 receptor agonists on the market today.
- Anesthesia considerations that need to be addressed.
- Unpacking Cyclopentenophenanthrene.
- Looking at the study: Characteristics and outcomes of patients hospitalized following a pulmonary aspiration.
Resources for this episode:
Beam, W. & Guevera, L. (2023). Are Serious Anesthesia Risks of Semaglutide and Other GLP-1 Agonists Under-Recognized? Case Reports of Retained Solid Gastric Contents in Patients Undergoing Anesthesia. Retrieved from: https://www.apsf.org/article/are-serious-anesthesia-risks-of-semaglutide-and-other-glp-1-agonists-under-recognized/
Dzaye, O., Berning, P., Razavi, A. C., Adhikari, R., Jha, K., Nasir, K., Ayers, J. W., Mortensen, M. B., & Blaha, M. J. (2022). Online searches for SGLT-2 inhibitors and GLP-1 receptor agonists correlate with prescription rates in the United States: An infodemiological study. Frontiers in Cardiovascular Medicine, 9, 936651–936651. https://doi.org/10.3389/fcvm.2022.936651
Flynn, D., Doyal, A., & Schoenherr, J. (2023). Gastric Ultrasound. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK580524/
Hurren, K. M., & Pinelli, N. R. (2012). Drug-Drug Interactions with Glucagon-Like Peptide-1 Receptor Agonists. The Annals of Pharmacotherapy, 46(5), 710–717. https://doi.org/10.1345/aph.1Q583
Lee, A., Festic, E., Park, P. K., Raghavendran, K., Dabbagh, O., Adesanya, A., Gajic, O., & Bartz, R. R. (2014). Characteristics and Outcomes of Patients Hospitalized Following Pulmonary Aspiration. Chest, 146(4), 899–907. https://doi.org/10.1378/chest.13-3028
Mitina, A. (2023). New guidance suggests skipping Ozempic before surgery
Have surgery coming up? Talk to your doctor about pausing Ozempic. Retrieved from: https://abcnews.go.com/Health/can-i-take-ozempic-before-surgery/story?id=101355578
Perlas, A, & Kruisselbrink, R. (2021). POCUS Spotlight: Gastric Ultrasound. Retrieved from: https://www.asra.com/news-publications/asra-newsletter/newsletter-item/asra-news/2021/11/01/pocus-spotlight-gastric-ultrasound
Sanivarapu, R. & Gibson, J. (2023). Aspiration Pneumonia. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK470459/
Van de Putte, P. & Bouvet, L. (2023). Gastric volume assessment (clear fluids). Retrieved from: https://www.gastricultrasound.org/en/acquisition/#volume
Vigara, L. A., Villanego, F., Orellana, C., Naranjo, J., Torrado, J., Garcia, T., & Mazuecos, A. (2022). Effectiveness and safety of glucagon‐like peptide‐1 receptor agonist in a cohort of kidney transplant recipients. Clinical Transplantation, 36(5), e14633–n/a. https://doi.org/10.1111/ctr.14633
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GLP-1 receptor agonists are like the slow motion button for your stomach. And this is really a critical point. They slow down gastric emptying, keeping those post-dinners sugar surprises in check, and a few other benefits like appetite suppression, cardiovascular and renal benefits to boot.