PDF(Pubmed)
Abstract：
Glucagon-like peptide-1 (GLP-1) agonists are very popular and useful medications for the treatment of type 2 diabetes mellitus and obesity. Potent gastric emptying delay is common with these medications, serving as a major contributor to the postprandial glycemic control and weight loss benefits of these medications. Recently, multiple case reports and studies indicating safety risks for these medications and their use in patients planning to undergo general anesthesia have been published, as retained gastric contents can lead to intraoperative aspiration. New guidelines for these medications have been released to guide clinical practice for anesthesiologists. Some degree of preoperative cessation of these medications is required. At this time, the ideal window for cessation of these medications to optimize clinical efficacy while reducing aspiration risks has not yet been well elaborated on. Aspiration of gastric contents can still occur despite appropriate preoperative fasting in patients taking GLP-1 agonists. Gastric ultrasound appears to be an effective and objective way of preoperatively assessing a patient\'s stomach contents to make decisions regarding anesthetic management for patients prescribed these medications. This practice is limited by a general lack of training and implementation in current anesthesiology practice.
摘要：
胰高血糖素样肽-1(GLP-1)激动剂是非常流行和有用的用于治疗2型糖尿病和肥胖症的药物。强效胃排空延迟在这些药物中很常见，这些药物是餐后血糖控制和减肥益处的主要因素。最近,已经发表了多个病例报告和研究，表明这些药物的安全风险及其在计划接受全身麻醉的患者中的使用，因为保留的胃内容物可导致术中误吸。这些药物的新指南已经发布，以指导麻醉师的临床实践。需要一定程度的术前停止这些药物治疗。此时,停用这些药物以优化临床疗效,同时降低误吸风险的理想窗口尚未得到很好的阐述.尽管在服用GLP-1激动剂的患者中进行了适当的术前禁食，但仍可能发生胃内容物的抽吸。胃超声检查似乎是一种有效且客观的方法，可以在术前评估患者的胃内容物，从而决定对这些药物的患者进行麻醉管理。这种做法受到当前麻醉实践中普遍缺乏培训和实施的限制。
