137 GLP1 agonists and anaesthesia a discussion with Erin

The next patient on your elective list arrives in theatre. She is a 35 year old woman booked for hysteroscopy to investigate her menorrhagia. She has no co-morbidities so wasn't seen preoperatively in a clinic. She tells you that she has no medical problems but did start on Wegovy for weight loss about 4months ago and has now lost about 12kg. She hasn't eaten anything since 9pm last night - it is now 10am. You were planning a general anaesthetic and a supra-glottic device, but now you're not sure what you should do?

Hi everyone,

This week I am joined by Erin and we discuss in detail the perplexing topic of GLP1 receptor agonists. These new wonder weight loss drugs seem to be all the rage and certainly things look rosy if you have shares in Novo Nordisk (the manufacturer). However they are not so great if you provide anaesthesia.... We discuss their relationship with delayed gastric emptying and the risk of aspiration.

References

ANZCA GLP1 clinical practice recommendation June 2024

ASA consensus based guidance on preoperative management of GLP1 agonists Feb 2024

Gastricultrasound.org. - This is the best resource available (our humble opinion) if you want to upskill yourself to be able to assess the contents of the stomach.

ANZCA clinical practice recommendation summary - June 2024 see below