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78th Annual PostGraduate Assembly in Anesthesiology (PGA78) 2024
December 6 - 9, 2024 | New York City
4111
Anesthesiologists' Perspectives on GLP-1 Receptor Agonists in Elective Surgeries: A Qualitative Survey Analysis of National Data
Poster Presenter
Authors
Affiliations
Part of Topic
Anesthesiologists’ Perspectives on GLP-1 Receptor Agonists in Elective Surgeries: A National Qualitative Survey Analysis
Benjamin Boudreau MS4, Nicholas Watson MD, FASA
Grand Rapids, Michigan
Introduction
GLP-1 RAs are a novel class of drugs that are becoming more common in the surgical population.
The effect on gastric emptying theoretically increases risk for pulmonary aspiration during anesthesia.
In 2023 the American Society of Anesthesiologists published a consensus-based guidance for the preoperative management of these patients.
ASA update Oct 29th, 2024:
Low risk patients can continue GLP-1 RAs through the perioperative period
High risk patients: consider a 24-hour liquid diet, gastric POCUS, holding GLP1-RAs per 2023 guidance
Purpose
The purpose of this study is to gather and analyze the perspectives of currently practicing anesthesiologists regarding their experiences with patients taking GLP-1 RAs and their thoughts regarding the ASA’s 2023 guidance.
Methods
This study was assigned exempt status by MSU’s IRB and developed through an iterative review process with focus group, expert validation, and cognitive pretesting.
12 multiple choice questions, 1 open-ended free response question.
Hosted on Qualtrics and sent to all members of West Michigan Anesthesiology (WMA) then to 27 private and academic institutions with a forwarding link.
Survey was held open for June – July 2024.
Results
A total of 232 responses were recorded
51.6% response rate within WMA (n=61)
Most respondents were >10 years of practice (61.2%) and 66.38% saw a GLP-1 RA patient at least once a week.
Most anesthesiologists see patients being properly instructed (68%) and correctly following (63%) the holding of their GLP-1 RAs “often” or “always”.
Symptoms most likely to lead to case cancellation:
Vomiting, Nausea, Fullness, Bloating, Upset Stomach
Multivariate Analysis:
Years of practice was strongly correlated to rate of reading the ASA’s 2023 guidance document.
V= 0.20, p = 0.008
Frequency of seeing GLP-1 RA patients was strongly correlated to having patients correctly following preoperative holding instructions.
V= 0.455, p < 0.001
Discussion & Conclusion
This study showed that while most anesthesiologists agree with the ASA’s 2023 guidance, there is still uncertainty regarding proper preoperative holding instructions.
Free text responses cite the need for more definitive research for applicability to broader patient presentations and case varieties.
Acknowledgements
Thank you to MSU CSTAT for the data analysis.