ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025
GLP-1 receptor agonist utilization is associated with a low risk of Anesthesia-related complications prior to total joint arthroplasty.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionGlucagon-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).
methodsAll 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.
resultsIn 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.
conclusionDespite 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.
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