Updated GLP-1 Perioperative Protocol - 2025 January

On behalf of Dr. J Huang - 2025 January

In keeping with recent changes in the recommendations regarding management of patients on GLP-1 agonists preoperatively, the following changes have been made:

1. GLP-1 RA therapy may be continued preoperatively in patients with the following exceptions:

• • Within the first 3 months of the escalation phase of their treatment.

  • Patients who have symptoms of GI intolerance ie nausea and vomiting, bloating, abdominal pain, or dyspepsia.

  • Weekly dosing.

In these patients, hold a week prior to surgery for weekly formulations and hold on the day of surgery for daily formulations.

2. Change in fasting instructions as follows to minimize the risk for aspiration.

• • Fast for solids and thick fluids for 24 hours preoperatively. i.e. clear fluids for 24 hrs before surgery.

  • NPO 4 hours prior to surgery

3. If fasting instructions have not been followed the patient may be cancelled on the day of surgery.

4. If there are still active GI symptoms, recommend gastric ultrasound and manage accordingly.