The problem with anesthesia & weight loss drugs like Ozempic

Weight loss drugs like Ozempic and Wegovy have become extremely popular in the last several years. But these drugs are creating problems for anesthesiologists, so much so that new clinical guidelines have been released by the American Society of Anesthesiologists.

Follow APSF on social media:

Studies cited:

0:00 Start
0:34 What are these drugs
2:36 Anesthesia & the stomach
3:40 Concerning case reports
4:53 New guidelines

Music:

The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional.

#Anesthesiology #Residency #MedicalSchool

[barbtries]

thank you - I'm on Ozempic and had surgery in January. I don't recall being advised to not take the Ozempic prior to surgery, which was performed one day before my weekly shot. I had no problems with aspiration at any rate, but this is good to know because I'll discuss it next time with my doctor to get clear instructions.

[janetk]

I just had my pre-surgery visit to Cleveland Clinic and met your med school friend Michael Walters. He was so nice and helpful during a difficult day (too long of a story!). Thanks to you for explaining all of the different aspects of cardiac anesthesia and thanks to him for being there for me yesterday.

[Bhaventh]

I regularly watch your videos from India. I don't have any medical degree or relationship with the medical field, but your videos have ignited my enthusiasm and curiosity. Basically, I am a civil engineer.

[brettlamont]

What about people with gastroparesis? Are they advised a longer period of no food or water?

[dodimichaud]

In January 2023, I had general anesthesia for back surgery. I was taking Ozempic and no one told me to stop it although they knew I was taking it. They informed me that there was food in my stomach at the time of anesthesia. I did have a bit of aspiration but it wasn’t consequential, luckily.

[chuck]

Max. Come to Wisconsin. Awesome Health Systems here. You could lead anesthesiology or any department you chose to. At any hospital or hospital system here. We would be honored by you coming here

[billydunwoody]

I was on Mounjaro and had surgery in March. MAC. No one ever told me to not take my Mounjaro and neither my surgeon nor anesthesiologist was concerned about the drug. Luckily nothing happened. Now I am on Ozempic and will definitley remind my doctors if I ever have surgery again.

[laurmichelle]

I’ve had very severe Gastroparesis (chronic delayed gastric emptying) for 15 years, since I was 13, and I CANNOT stress how important everything you mentioned in this video is enough!

Even though I solely rely on tube feeds and TPN, my anesthesia plan often changes/is dependent on how nauseated I am on the day of the surgery or procedure, and if we believe I have an excessive amount of bile or acid in my stomach that we can’t drain out of my G tube completely, we opt for general over MAC, but MAC is always the default so we have the option to switch over if there are any issues.

Thank you as always for getting the critical information out there!

[GreggBB]

Thank you---really great information. You help us realize how complicated, on so many different levels, it is to safely and effectively provide anesthesia for various surgeries.

[darriontunstall]

Wow that was awesome and amazing ! I learned so much!!! I really enjoy donating to the anesthesiologist Foundation, since it was hard for me to go to college because of my cerebral palsy, I really wanted to be a anesthesiologist physician! I always learn a lot from you! You rock man

[frotoe]

Interesting. Seems like this would also make things like colonoscopies tougher. Having had a couple, it's already not fun. They demanded I not eat a thing for like... 32+ hours before the procedure? (going from memory, it was "stop eating by midnight, don't eat next day while doing the "cleanse" and then get the procedure somewhere between 8am and 2pm.) It would really suck if you had to extend that another day because your stomach empties slowly.

[knnzzzz]

Would Reglan help in cases like these? ex: patient needing emergency surgery but was on a GLP1 med?

[izabelbrailovsky]

@MaxFeinstein can you talk about managing airways during anesthesia for patients with severe motility disorders. I have severe gastroparesis and chronic intestinal pseudo obstruction and am TPN dependent. What does managing anesthesia and airways look like for patients like myself?

[tarablum]

I had surgery yesterday morning, and I take Ozempic. I did not skip my dose, since it was due yesterday evening (I take it weekly). Because I take Ozempic, I had to have general (endotracheal) anesthesia, but I was also told they put in an orograstric tube to make sure I had nothing in my stomach.

[Trinket]

Thank you for getting this out there..im on ozempic and fortunately read about this before an mri which i was told to fast for. I had to call them and explain this whole thing..they hadnt heard about it!

[acres]

I am, unfortunately, all too familiar with this. I have Gastroparesis, Esophageal Immobility Disorder AND I take Rybelsus for my Type 2 Diabetes. My stomach just never really empties.

[wong]

Doctor Max: Is IV raglan still used in cases of delayed gastric mobility?

[ashleyferguson]

Wow, interesting! Congrats! SIX years post-op here! I've been through the weight loss, the regain and the re-loss. It is a journey! Charting my stats helped me, majorly! I even created a FREE planner/tracker to share with anyone that would like to try it

[knzay]

Yup, one of my abdominoplasty patients who was on wegovy puked during the case- anesthesiologist was not pleased

[amandajames]

Very interesting. I take mounjaro amd was told to stop taking ot 2 weeks before my recent surgery. I was told it was because my blood glucose could drop. Whatever the reason, all went very well with my procedure.