GLP-1受体激动剂患者的围手术期管理：风险、建议和未来方向

IF 5 2区医学 Q1 ANESTHESIOLOGY

Journal of Clinical Anesthesia Pub Date : 2025-05-15 DOI:10.1016/j.jclinane.2025.111871

Xiao-Yu Li MD , Yun Jin MM , Xiu-Ye Feng MM , Rui-Chun Wang MD , Jun-Ping Chen MD , Bo Lu MD

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引用次数: 0

摘要

胰高血糖素样肽-1受体激动剂（GLP-1RAs）越来越多地用于血糖控制和体重管理。它们的关键作用机制之一被认为是延缓胃排空。本综述探讨了与GLP-1RAs使用相关的围手术期风险，特别是胃内容物潴留和肺误吸的风险增加。目前的证据表明，接受GLP-1RAs治疗的患者应考虑在手术期间胃饱的风险。建议包括仔细评估用药细节，额外的监测和预防措施，如麻醉前胃超声和快速序列诱导。对于GLP-1RAs使用者的围手术期管理，需要进一步的研究来建立全面的指南。与麻醉期间使用GLP-1RAs相关的不良事件应全面记录，这对未来的指导方针和提高患者安全至关重要。

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Perioperative management of patients on GLP-1 receptor agonists: Risks, recommendations, and future directions—A narrative review

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly being used for glycemic control and weight management. One of their key mechanisms of action is thought to be delaying gastric emptying. This review explores the perioperative risks associated with GLP-1RAs use, particularly the increased risk of gastric content retention and pulmonary aspiration. Current evidence suggests that patients on GLP-1RAs should be considered at risk for having a full stomach during surgery. Recommendations include careful assessment of medication details, additional monitoring, and preventive measures such as pre-anesthesia gastric ultrasound and rapid sequence induction. Further research is needed to establish comprehensive guidelines for the perioperative management of GLP-1RAs users. Adverse events related to GLP-1RAs use during anesthesia should be thoroughly documented, which is essential to inform future guidelines and to enhance patient safety.

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来源期刊

Journal of Clinical Anesthesia 医学-麻醉学

CiteScore

7.40

自引率

4.50%

发文量

346

审稿时长

23 days

期刊介绍： The Journal of Clinical Anesthesia (JCA) addresses all aspects of anesthesia practice, including anesthetic administration, pharmacokinetics, preoperative and postoperative considerations, coexisting disease and other complicating factors, cost issues, and similar concerns anesthesiologists contend with daily. Exceptionally high standards of presentation and accuracy are maintained. The core of the journal is original contributions on subjects relevant to clinical practice, and rigorously peer-reviewed. Highly respected international experts have joined together to form the Editorial Board, sharing their years of experience and clinical expertise. Specialized section editors cover the various subspecialties within the field. To keep your practical clinical skills current, the journal bridges the gap between the laboratory and the clinical practice of anesthesiology and critical care to clarify how new insights can improve daily practice.