Nurses who specialize in anesthesia have issued new guidelines to reduce the risk that patients taking weight-loss drugs like Ozempic or Wegovy throw up during surgery.

“These medications have exploded in popularity,” said Micah Walden, of the American Association of Nurse Anesthesiology (AANA) Practice Committee. “This means additional preparation for patients, anesthesia providers and the surgical team to help minimize risks of complications during a procedure.”

Because general anesthesia can cause nausea, patients are usually asked to fast before surgery. But a study published last week in the journal JAMA Surgery found these weight-loss drugs — called GLP-1 receptor agonists — slow digestion, so it takes longer for food to leave the stomach. That increases a patient’s risk of vomiting or aspiration while under anesthesia.

GLP-1 agonists like Ozempic, Wegovy (semaglutide), Saxenda (liraglutide) or Zepbound (tirzepatide) were originally designed to manage type 2 diabetes, but they have become a popular way to lose weight. They make patients feel full sooner, so they eat less.

As a precaution, the AANA committee said providers may need to do extra screenings such as an ultrasound of the patient’s stomach before surgery. If the examination indicates that the stomach is not empty or the imaging is inconclusive, the surgical team may consider delaying an elective surgery or proceeding as “full stomach” to reduce the risk of vomiting and aspiration while the patient is intubated for anesthesia care, the committee said.

As they developed their recommendations, members of the practice committee said they considered the length of time various GLP-1 medications continue to affect patients. 

They recommend withholding medication for a week before surgery if patients take a weekly dose. Those on a daily dose should not use the medication on the day of procedure, the recommendations advise.

The recommendations were published March 12.

“Open communication between patients and the surgical team is important to recommendations for withholding GLP-1 agonist medications prior to surgery,” Walden said in an AANA news release. “As providers, we take that information into account to perform an individualized, case-by-case assessment and create a care plan that will keep the patient safe and comfortable before, during and after the procedure.”

More information

The Obesity Medicine Association has more about popular weight-loss medications.

SOURCE: American Association of Nurse Anesthesiology, news release, March 12, 2024