PDF(Pubmed)
Abstract：
Glucagon-like peptide receptor agonists (GLP-1RA) are used to treat type 2 diabetes mellitus and, more recently, have garnered attention for their effectiveness in promoting weight loss. They have been associated with several gastrointestinal adverse effects, including nausea and vomiting. These side effects are presumed to be due to increased residual gastric contents. Given the potential risk of aspiration and based on limited data, the American Society of Anesthesiologists updated the guidelines concerning the preoperative management of patients on GLP-1RA in 2023. They included the duration of mandated cessation of GLP-1RA before sedation and usage of \"full stomach\" precautions if these medications were not appropriately held before the procedure. This has led to additional challenges, such as extended waiting time, higher costs, and increased risk for patients. In this editorial, we review the current societal guidelines, clinical practice, and future directions regarding the usage of GLP-1RA in patients undergoing an endoscopic procedure.
摘要：
胰高血糖素样肽受体激动剂(GLP-1RA)用于治疗2型糖尿病,最近,它们在促进减肥方面的有效性引起了人们的注意。它们与几种胃肠道不良反应有关，包括恶心和呕吐。推测这些副作用是由于残留的胃内容物增加。考虑到潜在的误吸风险，并基于有限的数据，美国麻醉医师协会于2023年更新了GLP-1RA患者术前管理指南.其中包括在镇静前强制停止GLP-1RA的持续时间，以及如果在手术前没有适当地服用这些药物，则使用“全胃”预防措施。这导致了更多的挑战，例如延长等待时间，更高的成本，增加患者的风险。在这篇社论中，我们回顾了当前的社会指导方针，临床实践，以及未来关于GLP-1RA在接受内镜手术的患者中使用的方向。
