You have an elective surgery. You made plans to take PTO and have a friend or family member travel into town to assist with your recovery.
On the day of surgery, you present to the Surgery Center wide-eyed and bushy tail. You go through the discomfort of an Intravenous access and then you are told “ Sorry, we can’t proceed with your surgery.” Because you didn’t stop your GLP-1 for a week.
If you have surgery at Continuum Surgery Center Of Naples, you won’t ever need to worry about this happening.
This decade began with two major events to shake up humanity – COVID-19 & GLP-1 – both of which are here to stay.
Research into Glucagon-like Peptide-1 Receptor Agonists (GLP-1) began in the 1980s. The FDA approved Byetta in 2005 for Type-2 diabetes. In 2010 Victoza was approved for weight loss. In 2017 Semaglutide was approved for Type-2 Diabetes and weight loss in 2021. With celebrities and Social Media popularizing the weight loss effects, GLP1s became a household name. With fame came detractors. There were reports that many patients taking the GLP1s suffered from delayed stomach emptying ( gastroparesis) which increased their risk of aspiration during surgical procedures.
With great fanfare, in 2023, an alphabet soup of Medical/Surgical societies, without high-level evidence made a blanket statement that patients on GLP1s should halt their treatment for at least a week. Which subsequently led to the scenario at the beginning of the essay.
GLP1s has benefits for:
. Diabetes
. Weight loss
. Cardiovascular disease
. Polycystic Ovarian Syndrome
. Infertility
. Osteoarthritis
. Alcohol consumption
A known side effect of diabetes is gastroparesis. A biomechanic effect of diabetic medications such as Metformin, Lyraglutide, Ozempic, Wegovy etc. is gastroparesis. Knowing this, our Anesthesiologists have treated all diabetics and patients on GLP1s as if they are at high risk for gastroparesis. Based on your medical/surgical history, we may have you adjust your meal intake from our usual 6 hours and 2 hours for drinking. We may administer antacids, prokinetics, antisecretalogues and do a bedside stomach ultrasound scan.
What the Medical Societies guidance didn’t mention is the timing to reverse gastroparesis; the level of patient compliance with stopping the medications preop; aspiration increase v risk of aspiration in those who halted the meds v status quo.
In November 2024, without fanfare, five Societies, including the American Society of Anesthesiology, released a new guidance on GLP1 use and surgery. That guidance agreed with our practice. However, the majority of ASCs and Hospitals are slow to adjust.
We look forward to seeing you, where we practice Humanism in Medicine.
G-A Lawson-Bouchér, MD DABA
Medical Director
Moonlight Anesthesia Services
Continuum Surgery Center Of Naples
Dr. Gary-Anthony Lawson-Boucher, MD is an anesthesiology specialist in southwest Florida and has over 22 years of experience in the medical field. He graduated from New Jersey Medical School in 1999.
Dr. Lawson has lived in Naples for 2 decades, where he practices Ambulatory Surgery Anesthesia. He has practiced on 3 continents, during 2 wars with the U.S. Navy 7th Fleet and Marine Expeditionary Forces. He is an early proponent of enhanced recovery and the use of multimodal analgesia to effect painless surgery. He relies on his family’s multicultural background to drive his principle of Humanism in Medicine.
Join Our Team
We are actively seeking talented healthcare professionals including surgical nurses, radiation techs, Pre-Op and PACU nurses, surgical techs, and front desk professionals. Submit your CV to Marisa@csc-surgerycenternaples.com.
For surgeons seeking credentialing or shareholder opportunities, contact Marisa directly at 561-789-8435.
Continuum Surgery Center of Naples — Welcome to the future of surgical care.
Continuum Surgery Center of Naples
239-504-0004
6750 IMMOKALEE ROAD, STE. 211
NAPLES, FL 34119
www.continuumsurgerycenter.com
info@continuumsurgerycenter.com