The impact of glucagon-like peptide-1 receptor agonists in the patients undergoing anesthesia or sedation: systematic review and meta-analysis

Autor: Tatiana S. do Nascimento, Rodrigo O. L. Pereira, Eduardo Maia, Tetsu Ohnuma, Mariana G. da Costa, Eric Slawka, Carlos Galhardo, Vijay Krishnamoorthy
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Perioperative Medicine, Vol 13, Iss 1, Pp 1-13 (2024)
Druh dokumentu: article
ISSN: 2047-0525
DOI: 10.1186/s13741-024-00439-y
Popis: Abstract Background Glucagon-like peptide-1 agonist receptors (GLP-1RAs), medications used for glycemic control and weight loss, are increasing worldwide. In the perioperative period, the major concern related to GLP-1RA is gastric emptying delay and risk of aspiration. This meta-analysis and systematic review compared the risks and benefits of using GLP-1 agonist receptors and control in surgical and nonsurgical procedures under anesthesia or sedation. Methods We systematically searched MEDLINE, Embase, and Cochrane for randomized controlled trials and observational studies involving patients > 18 years undergoing elective surgeries or procedures. Outcomes of interest were pre-procedural gastrointestinal (GI) symptoms, residual gastric content assessed by endoscopy, pulmonary aspiration during anesthesia/sedation, perioperative glycemic control, postoperative inotropic support, nausea/vomiting (PONV), atrial fibrillation, and 30-day mortality rate. We used a random effects model, with odds ratio and mean difference computed for binary and continuous outcomes, respectively. Results Fourteen randomized and observational studies with 2143 adult patients undergoing elective surgeries and procedures were included. GLP-1RA resulted in increased pre-procedural GI symptoms (OR 7.66; 95% CI 3.42, 17.17; p
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