GLP-1 Medications (Ozempic, Wegovy) and Anesthesia

Why your anesthesiologist asks

GLP-1 receptor agonists slow gastric emptying. During sedation or general anesthesia, food or fluid remaining in the stomach is a concern because it could travel into the lungs, which is called pulmonary aspiration. A 2024 review in the British Journal of Anaesthesia summarised the evidence: the delay in gastric emptying is real, but ongoing treatment appears to attenuate it. The actual risk of aspiration during general anesthesia is unknown, and the authors advise caution in people who recently started a GLP-1 medication. After more than 12 weeks of treatment, standard fasting times likely suffice for most otherwise low-risk patients.

Recommendations differ

Professional guidance in this area has changed over time and is not identical between organizations. That is why your anesthesiologist will individualize the plan rather than apply a single rule.

What to do

• Tell us the name of the medication, the dose, how often you take it and when you started or last changed the dose.
• Tell us if you have nausea, vomiting, bloating or fullness.
• Do not stop or change a prescribed medication on your own. Follow the written instructions your team gives you.
• Follow your fasting instructions exactly. Your team may give you additional instructions.

Awake surgery under local anesthesia without sedation reduces some airway considerations, but the plan can change on the day, so the information still matters.

Explore your options at a consultation

References

1. van Zuylen ML, Siegelaar SE, Plummer MP, Deane AM, Hermanides J, Hulst AH. Perioperative management of long-acting glucagon-like peptide-1 (GLP-1) receptor agonists: concerns for delayed gastric emptying and pulmonary aspiration. Br J Anaesth. 2024;132(4):644-648. PMID 38290907