'''If you take a GLP-1 medicine and you have a procedure booked, raise it with both your surgical and your anaesthesia teams.''' Guidance published in 2024 by several societies together sets out how that conversation is meant to go.
== The decision is shared ==
The guidance puts it plainly: "Use of GLP-1RAs in the perioperative period should be based on shared decision-making of the patient with procedural, anesthesia, and prescribing care teams balancing the metabolic need for the GLP-1RA with individual patient risk" (Kindel TL et al., ''Surgery for Obesity and Related Diseases'', 2024 · [https://doi.org/10.1016/j.soard.2024.08.033 doi:10.1016/j.soard.2024.08.033]).
== Continuing is possible ==
"GLP-1RA therapy may be continued pre-operatively in patients without elevated-risk of delayed gastric emptying and aspiration" (Kindel TL et al., ''Surgery for Obesity and Related Diseases'', 2024 · [https://doi.org/10.1016/j.soard.2024.08.033 doi:10.1016/j.soard.2024.08.033]).
== What raises the risk ==
The guidance names these (Kindel TL et al., ''Surgery for Obesity and Related Diseases'', 2024 · [https://doi.org/10.1016/j.soard.2024.08.033 doi:10.1016/j.soard.2024.08.033]):
- Being in the '''dose-escalation phase''' rather than on a settled dose
- A '''higher dose'''
- '''Weekly''' rather than daily formulations
- Current '''GI symptoms''' (nausea, vomiting, abdominal pain suggestive of delayed emptying)
== If a pause is chosen ==
Where holding is decided on, the guidance points to the original anaesthesia timing: "hold the day of surgery for daily formulations, and a week prior to surgery for weekly formulations" (Kindel TL et al., ''Surgery for Obesity and Related Diseases'', 2024 · [https://doi.org/10.1016/j.soard.2024.08.033 doi:10.1016/j.soard.2024.08.033]).
== One of the mitigations ==
Where there is concern about delayed emptying, a "preoperative liquid diet for at least 24 h" can be used (Kindel TL et al., ''Surgery for Obesity and Related Diseases'', 2024 · [https://doi.org/10.1016/j.soard.2024.08.033 doi:10.1016/j.soard.2024.08.033]).
== What Loopa does ==
If you have a GLP-1 protocol and you set a scheduled procedure date, Loopa raises this card so the conversation happens. '''It does not tell you to stop, to continue, or to pause for any number of days.''' Your teams write that down between them; follow what they wrote.
== Related ==
- [[medication-protocols|Medication protocols]]
- [[medications-and-surgery|Medications and surgery]]
- [[preparing-for-surgery|Preparing for surgery]]
== Where this comes from ==
Everything on this page is drawn from published clinical guidelines and peer-reviewed research, cited above. '''Loopa does not give medical advice.''' It does not decide whether a procedure is right for you, does not recommend one over another, and never sets a dose. Your care team does all three, and where they give you an instruction, theirs is the one to follow.
'''If you take a GLP-1 medicine and you have a procedure booked, raise it with both your surgical and your anaesthesia teams.''' Guidance published in 2024 by several societies together sets out how that conversation is meant to go. == The decision is shared == The guidance puts it plainly: "Use of GLP-1RAs in the perioperative period should be based on shared decision-making of the patient with procedural, anesthesia, and prescribing care teams balancing the metabolic need for the GLP-1RA with individual patient risk" (Kindel TL et al., ''Surgery for Obesity and Related Diseases'', 2024 · [https://doi.org/10.1016/j.soard.2024.08.033 doi:10.1016/j.soard.2024.08.033]). == Continuing is possible == "GLP-1RA therapy may be continued pre-operatively in patients without elevated-risk of delayed gastric emptying and aspiration" (Kindel TL et al., ''Surgery for Obesity and Related Diseases'', 2024 · [https://doi.org/10.1016/j.soard.2024.08.033 doi:10.1016/j.soard.2024.08.033]). == What raises the risk == The guidance names these (Kindel TL et al., ''Surgery for Obesity and Related Diseases'', 2024 · [https://doi.org/10.1016/j.soard.2024.08.033 doi:10.1016/j.soard.2024.08.033]): * Being in the '''dose-escalation phase''' rather than on a settled dose * A '''higher dose''' * '''Weekly''' rather than daily formulations * Current '''GI symptoms''' (nausea, vomiting, abdominal pain suggestive of delayed emptying) == If a pause is chosen == Where holding is decided on, the guidance points to the original anaesthesia timing: "hold the day of surgery for daily formulations, and a week prior to surgery for weekly formulations" (Kindel TL et al., ''Surgery for Obesity and Related Diseases'', 2024 · [https://doi.org/10.1016/j.soard.2024.08.033 doi:10.1016/j.soard.2024.08.033]). == One of the mitigations == Where there is concern about delayed emptying, a "preoperative liquid diet for at least 24 h" can be used (Kindel TL et al., ''Surgery for Obesity and Related Diseases'', 2024 · [https://doi.org/10.1016/j.soard.2024.08.033 doi:10.1016/j.soard.2024.08.033]). == What Loopa does == If you have a GLP-1 protocol and you set a scheduled procedure date, Loopa raises this card so the conversation happens. '''It does not tell you to stop, to continue, or to pause for any number of days.''' Your teams write that down between them; follow what they wrote. == Related == * [[medication-protocols|Medication protocols]] * [[medications-and-surgery|Medications and surgery]] * [[preparing-for-surgery|Preparing for surgery]] == Where this comes from == Everything on this page is drawn from published clinical guidelines and peer-reviewed research, cited above. '''Loopa does not give medical advice.''' It does not decide whether a procedure is right for you, does not recommend one over another, and never sets a dose. Your care team does all three, and where they give you an instruction, theirs is the one to follow.
