A new study by Canadian researchers supports the safety of continued perioperative Glucagon-like peptide-1 receptor agonist (GLP-1RA) use in “patients meeting strict institutional pre-procedure screening pathways for short-duration ophthalmic surgeries under MMS [Mild-To-Moderate Sedation] in an ambulatory setting.”
However, the researchers caution that their findings “may not extend to higher risk patients excluded by institutional criteria.”
The study, titled “Perioperative Desaturation and Postoperative Nausea or Vomiting Requiring Antiemetic Administration in Glucagon-Like Peptide-1 Receptor Agonist Users Undergoing Ambulatory Ophthalmic Surgery Under Mild-To-Moderate Sedation: A Large Retrospective Cohort Study,” was published in Diabetes, Obesity and Metabolism.
Noting that GLP-1RAs “delay gastric emptying and are implicated in perioperative pulmonary aspiration,” the researchers evaluated whether GLP-1RA use is associated with perioperative desaturation and/or postoperative nausea or vomiting (PONV) during ambulatory ophthalmic surgery using MMS.
The retrospective, observational cohort study examined tens of thousands of adults who underwent surgery under MMS at the Kensington Eye Institute between January 2022 and December 2024. Patients were classified as GLP-1RA users or non-users. “Primary outcomes were desaturation < 90% and PONV requiring antiemetic administration,” they write. “Associations were assessed using univariate and multivariable logistic regression adjusted for risk factors and potential confounders using a generalized estimating equation (GEE) approach.”
“In this cohort, no desaturation events occurred, although PONV was more frequent amongst GLP-1RA users,” they write. “Future guidelines need to incorporate patient-centered symptomatology to guide clinicians in perioperative management of GLP-1RA use.”
