P069: SCOPING REVIEW ON PERIOPERATIVE COMPLICATIONS OF PATIENTS TAKING SEMAGLUTIDE
Daniel Naus, CAA, MS, OMSIII; Nicholas Gallo; Sahil Patel, OMSIII; Mario Rodriguez Alvarado, OMSIII; Murilo Alvez, OMSIII; Zachary Hudson, OMSIII; Sara Marchese, OMSIII; Jeffrey Joppen, OMSIII; Evan Reilly, OMSIII; Jeremy Paparozzi, OMSIII; Joshua Costin, PhD
Nova Southeastern University Kiran C. Patel College of Osteopathic Medicine
Background: Glucagon-like peptide was discovered after the administration of oral glucose produced a sustained increase of plasma insulin while the administration of intravenous glucose only produced a small increase in plasma insulin. Semaglutide, a GLP-1 receptor agonist, first gained FDA approval to treat type 2 diabetes. Now, Semaglutide is approved for the weight management of chronically overweight or obese adults with comorbidities associated with their weight, such as type 2 diabetes, hyperlipidemia, and hypertension. Preoperative recommendations found that GLP-1RA, including Semaglutide, was recommended to be taken as normal through surgery but emphasized the need for more research to confirm this finding. This becomes an important consideration for patients undergoing medical procedures as the effects of the medication may still be ongoing for an extended period after cessation. Given the gaps in the literature between semaglutide, anesthesia, aspiration, and delayed gastric emptying, this review will create an understanding of the risks involved in taking semaglutide while undergoing anesthesia.
Objective: The objective of this study is to determine the extent of the perioperative complications for patients who take GLP-1 agonist, semaglutide, and undergo anesthesia.
Methods: This study was designed to be a retrospective scoping review using data previously gathered for patient care. The patient data used in this study was selected using the following criteria 1) Over the age of 12 years old. 2) the participants have had to have a medical procedure done ranging from gastric bypass to liver transplantation. 3) The participants needed to have taken GLP-1 receptor agonist semaglutide. A total of eight articles met this criterion. The research data was gathered using Embase.
Results: Of the 69 retrieved papers, a total of 8 studies were included in this review. This was accomplished by a two-tier review of the retrieved papers. For the selected studies, five studies found increased gastric content on endoscopy while under anesthesia. Identification of one study via screening mentioned increased risks and incidence of Myocardial infarction, pneumonia, hypoglycemic events and acute kidney injury following total knee arthroplasty. Two of the studies found that there were no perioperative complications associated with patients currently taking semaglutide.
Conclusion: With such a large number of patients taking semaglutide and undergoing surgery, this review highlighted the adverse interactions and patient clinical outcomes. The results of this study suggest that patients taking semaglutide and undergoing anesthesia or endoscopy showed increased gastric content/food, leading to further possible perioperative complications. Perioperative complications such as Myocardial infarction, pneumonia, hypoglycemic events, and acute kidney injury were seen in patients taking Semaglutide undergoing a total knee arthroplasty. One-quarter of the articles in this study found no direct correlation between perioperative complications and patients taking semaglutide.