GLP-1 receptor agonist utilization is associated with a low risk of Anesthesia-related complications prior to total joint arthroplasty.
This study found no acute intraoperative pulmonary aspiration among patients using GLP-1 receptor agonists before total joint arthroplasty, suggesting a low risk of anesthesia-related complications in this group.
Where it sits
this study against the rest of the semaglutide corpusSummary and findings
This study assessed the incidence of intraoperative and early postoperative complications in patients using GLP-1 receptor agonists prior to total joint arthroplasty. A total of 83 patients were included, with 63 (75.9%) receiving semaglutide. No cases of acute intraoperative pulmonary aspiration were identified, and 4 patients (4.8%) experienced medical complications within 90 days.
Abstract
<h4>Introduction</h4>Glucagon-like peptide-1 receptor agonists (GLP-1 RA) have recently garnered increased attention due to their effectiveness in inducing marked weight loss among overweight and obese adults. Recent evidence, however, has raised concerns about a potential link between GLP-1 receptor agonist therapy and perioperative pulmonary aspiration. In this single-institution retrospective series, we aimed to quantify the incidence of intraoperative and early postoperative complications among patients taking GLP-1 RA before elective total joint arthroplasty (TJA).<h4>Methods</h4>All patients who underwent primary TJA at our institution between April 2014 and October 2023 were initially screened. Patients were considered eligible for inclusion if they demonstrated consistent preoperative GLP-1 RA utilization. GLP-1 RA medication type, dosage, administration method, and treatment duration were tabulated for each patient. The primary outcomes of interest wereintraoperative anesthesia-related complications, particularly pulmonary aspiration, postoperative medical and surgical complications, and 90-day reoperation.<h4>Results</h4>In total, 83 patients demonstrated consistent GLP-1 RA usage before primary TJA. Of these patients, 63 (75.9%) received semaglutide, 19 (22.9%) liraglutide, and 1 (1.2%) tirzepatide. No cases of acute intraoperative pulmonary aspiration were identified. Intraoperative assessment of gastric contents was not routinely performed; however, one patient was noted to have a full stomach requiring nasogastric decompression. This individual was in the dose-escalation phase of treatment, having self-administered 1 mg of semaglutide five days before surgery. Four patients (4.8%) experienced 90-day medical complications, none of which were attributed to GLP-1 RA use, and one patient (1.2%) required reoperation.<h4>Conclusion</h4>Despite recent studies suggesting an elevated risk of acute intraoperative pulmonary aspiration, our findings underscore the rare nature of intraoperative anesthesia-related adverse events in TJA patients taking GLP-1 RA.
Background
The paper addresses the potential impact of GLP-1 receptor agonists on anesthesia-related complications during total joint arthroplasty. Prior research has suggested that certain medications may influence perioperative outcomes, but the specific role of GLP-1 receptor agonists in this context is not well established. This study aims to fill that gap by examining the relationship between these medications and anesthesia-related risks.
Methods
The study design is not specified in the abstract. The population includes patients undergoing total joint arthroplasty, but the exact sample size (n) is not reported. The dose and duration of GLP-1 receptor agonist administration are also not detailed. Primary and secondary outcome measures related to anesthesia complications are not specified.
Results
Not reported in abstract.
Interpretation
Without specific results, it is difficult to compare this study's findings to existing literature. The absence of reported effect sizes limits the ability to assess clinical significance. Potential confounds include the lack of detail on study design and population characteristics, which may affect the reliability of the conclusions drawn.
Key findings
- Not reported in abstract.
Limitations
- Not reported in abstract.