Beas-Magdaleno GA, Schmidt-Ramírez A, Muhlia-Pérez JE, Beas-Magdaleno D

Language: Spanish
References: 23
Page: 24-28
PDF size: 427.43 Kb.

ABSTRACT

Introduction: glucagon-like peptide-1 receptor agonists (GLP1-RAs) are increasingly used for the treatment of type 2 diabetes, and obesity which are known to delay gastric emptying. However, it is unknown whether their use may increase the risk of bronchoaspiration during anesthetic procedures. Objective: to conduct a systematic review of the current evidence on residual gastric contents, regurgitation and bronchoaspiration in semaglutide users undergoing anaesthetic procedures. Material and methods: a search of PubMed and the Cochrane Library was performed without language or time limits using the following terms: "fasting or gastric" "semaglutide" "anaesthesia". Original articles reporting the effect of semaglutide on gastric emptying and the risk of pulmonary aspiration in individuals undergoing anaesthesia were included. PRISMA criteria for systematic reviews and Cochrane recommendations were used. Results: fifteen articles were found, of which 10 were included in the final work. Consistent evidence was found that the use of semaglutide causes the presence of residual gastric content and increases the frequency of regurgitation and bronchoaspiration. The studies recommend implementing measures to prevent these complications, specially the use of preoperative gastric ultrasound to identify patients at risk of regurgitation and bronchoaspiration and considering discontinuing treatment with aGLP-1R on the day of the anesthetic surgical procedure and the dose of the previous week in those receiving daily or weekly prescription drugs, respectively. Conclusions: the use of aGLP-1R may increase the risk of bronchoaspiration and regurgitation during anesthetic procedures, so it is advisable to monitor the patient and implement measures to prevent these complications.

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