Ozempic users at higher risk of fatal complications during surgery: doctors

well being

By Related Press

August 13, 2023 | 4:10 p.m

Sufferers who take fashionable medication comparable to Wegovy or Ozempic for weight reduction might face life-threatening problems in the event that they want surgical procedure or different procedures that require an empty abdomen for anesthesia. This summer time’s tips for stopping treatment for as much as every week will not be sufficient, both.

Some anesthesiologists in america and Canada say they’ve seen rising numbers of sufferers on weight-loss medication who inhaled meals and fluid into their lungs throughout anesthesia as a result of their stomachs had been nonetheless full — even after following customary directions to cease consuming six to eight hours prematurely.

The medication can gradual digestion a lot that they put sufferers at elevated threat for this drawback, referred to as pulmonary aspiration, which might trigger critical lung injury, infections and even demise, mentioned Dr. Ion Hopai, an anesthesiologist at Massachusetts Normal Hospital in Boston.

“It is a critical kind of potential complication that everybody taking this treatment ought to pay attention to,” mentioned Hobai, who was among the many first to level out the issue.

Practically 6 million prescriptions had been written for the drug class that features Wegovy and Ozempic between January and Might in america for individuals with out diabetes, in accordance with Komodo Well being, a healthcare know-how firm. The medication induce weight reduction by primarily mimicking the actions of hormones within the intestine, which kick in after you eat. Additionally they goal the indicators between the intestine and the mind that management urge for food and emotions of fullness, and by slowing how shortly the abdomen empties.

In June, the American Affiliation of Anesthesiologists issued tips advising sufferers to skip each day weight-loss medicines on the day of surgical procedure and to carry off weekly injections for every week earlier than any anesthesia procedures. Dr. Michael Champeau, the group’s president, mentioned the motion was primarily based on anecdotal studies of issues – together with aspiration – from throughout the nation.

It isn’t clear what number of sufferers taking anti-obesity medicines could also be affected by this drawback. However because the penalties might be very dire, Hobai and a bunch of colleagues determined to talk out. Writing within the Canadian Journal of Anesthesiology, they advocate stopping the drug for longer — about three weeks earlier than anesthesia.

This explains how lengthy semaglutide, the lively drug in Wegovy, stays within the physique, mentioned Dr. Philip Jones, a Mayo Clinic anesthesiologist who can be the journal’s deputy editor.

“When 90% of it’s gone, after three weeks, hopefully the whole lot will probably be again to regular,” Jones mentioned.

Champeau and Jones acknowledge that there’s not sufficient proof to say with certainty how lengthy semaglutide have to be stored to make anesthesia protected. Champoo famous that many sufferers won’t meet with suppliers properly sufficient in time to cease the treatment three weeks earlier than the procedures.

Aspiration happens in 1 in each 2,000 to three,000 procedures requiring anesthesia, and roughly half of sufferers who breathe throughout surgical procedure develop a associated lung damage. However case studies present that new sufferers who took semaglutide skilled issues even after they stopped consuming as much as 20 hours earlier than their procedures.

“There’s nothing that claims for those who quick twice as lengthy, it’s going to be okay,” Champeau mentioned.

Among the many many studies detailing doubtlessly critical issues was one in all Hobai’s sufferers, a 42-year-old man in Boston who had lately began taking Wegovy, needed to be intubated and skilled respiratory failure that put him in intensive care. He was inhaling meals that remained in his abdomen regardless of having fasted for 18 hours.

In Chapel Hill, North Carolina, a 31-year-old lady taking a low dose of Ozempic fasted for 10 hours earlier than a routine endoscopy previous to bariatric surgical procedure final fall. The operation was stopped as a result of stable meals remained in her abdomen and she or he was at extreme threat of aspiration, the report mentioned.

Since then, medical doctors have seen dozens of comparable circumstances with rising use of the weight-loss drug, mentioned Dr. Elisa Lund, an anesthesiologist on the College of North Carolina at Chapel Hill College of Medication. “It is elevated dramatically,” she mentioned.

Hobai is finishing a retrospective research of almost 200 sufferers taking semaglutide. He mentioned that whereas it will likely be revealed later this 12 months, the work to date seems to substantiate a small research from Brazil. In that research, a couple of quarter of the sufferers who took semaglutide had meals leftovers of their stomachs throughout procedures that required anesthesia — even after stopping the drug for 10 days.

The American Society of Anesthesiologists advises questionable clinicians to deal with sufferers who have not paused the treatment as in the event that they had been on a full abdomen, which can imply utilizing various kinds of anesthesia protocols or delaying procedures, if doable. Jones added that analysis is urgently wanted to replace tips for medical doctors and sufferers.

Novo Nordisk, which makes Ozempic, Wegovy and comparable medication, mentioned the corporate’s scientific trial and post-marketing security knowledge didn’t present the medication led to aspiration. However the drug’s producer famous that the medication are recognized to trigger delayed abdomen emptying and that the labels warn of doable gastrointestinal unwanted effects.

Stopping medicines for 3 weeks may also trigger issues. Hopai mentioned individuals with diabetes will want one other method to management their blood sugar, and people searching for to drop some pounds might regain a few of it.

Hobai suggests that individuals utilizing Wegovy and comparable medicines inform their medical doctors earlier than anesthesia and focus on the dangers and advantages.

“When you’re on this treatment and want surgical procedure, you will have to take some additional precautions,” he mentioned.

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