Spine Care Delaware Policy for Glucagon-like Peptide-1 (GLP-1) Agonists

Glucagon-like peptide 1 agonists (GLP-1 agonists) are prescribed to help manage type-two diabetes, for cardiovascular risk reduction and weight management. Taking these medications prior to deep sedation can increase the risk of aspiration.

The American Society of Anesthesiologists now recommends holding these medications before any procedure requiring deep sedation.

Policy

Procedures at Spine Care Delaware that could potentially progress to deep sedation, such as Intracept Procedures and Orthobiologic Procedures, should follow the recommendations below:

For weekly dosing, hold the GLP-1 agonists for at least 7 days prior to the procedure. This means patients will skip one dose before their procedure.

For patients on daily GLP-1 agonists, hold the medication for at least 24 hours before the procedure. This means patients will skip one dose before their procedure.

If a patient taking a GLP-1 agonist presents for any procedure with GI symptoms such as severe nausea, vomiting, bloating, or abdominal pain this can be indicative of increased gastric volume. The anesthesia team should discuss the increased risk of aspiration and formulate a strategy to mitigate the increased aspiration risk, including considering delaying the procedure.

It is most common for patients to take these medications once a week. This means that medication instructions must come from the ordering physician’s office.

Medications