ICU sedation, delirium & recovery
The impact of glucagon-like peptide-1 receptor agonists in the patients undergoing anesthesia or sedation: systematic review and meta-analysis
Authors' conclusion
Compared to control, pre-procedural GLP-1RA increased the rate of GI symptoms and the risk of elevated residual gastric content despite adherence to fasting guidelines. GLP-1RA improved glycemic control and decreased the rate of rescue insulin administration. There was no significant difference in the rates of perioperative hypo or hyperglycemia, postoperative inotropic support, PONV, atrial fibrillation, and 30-day mortality.
Study context
- Population
- Adults (>18 years) undergoing elective surgeries or procedures under anaesthesia or sedation
- Participants
- 2,143 adults · 14 studies
- Comparison
- GLP-1RA vs control
- Outcome
- Pre-procedural gastrointestinal (GI) symptoms and residual gastric content (endoscopy)
Methodological detailsrandom effects model
- Random effects model
Pooled result
As reported in the abstract
GLP-1RA vs ControlOdds ratio (95% CI)P value
Pre-procedural GI symptoms; I2 = 0%
7.66(3.42–17.17)
P < 0.00001Elevated residual gastric content; I2 = 0%
6.08(2.86–12.94)
P < 0.00001Further pooled results
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Rescue insulin administrationI2 = 35% | 0.39 (0.23–0.68) | P = 0.0009 | |
| 0.20.5125Odds ratio (log scale) |
| Outcome | MD (95% CI) | P value |
|---|---|---|
| Glycemic levelsI2 = 90% | - 0.73 (- 1.13, - 0.33) | P = 0.0003 |
Postoperative inotropic support
- No significant difference; OR (95% CI), p, I2
- 0.57 (0.33, 1.01), p = 0.05, I2 = 0%
30-day mortality
- No significant difference; OR (95% CI), p, I2
- 0.54 (0.14, 2.05), p = 0.25, I2 = 0%
Safety
Perioperative hypoglycemia
- No significant difference; OR (95% CI), p, I2
- 0.60 (0.29, 1.24), p = 0.17, I2 = 0%
Perioperative hyperglycemia
- No significant difference; OR (95% CI), p, I2
- 0.89 (0.59, 1.34), p = 0.58, I2 = 38%
Atrial fibrillation
- No significant difference; OR (95% CI), p, I2
- 1.02 (0.52, 2.01), p = 0.95, I2 = 16%
PONV
- No significant difference; OR (95% CI), p, I2
- 1.35 (0.82, 2.21), p = 0.24, I2 = 0%
Original publication
The impact of glucagon-like peptide-1 receptor agonists in the patients undergoing anesthesia or sedation: systematic review and meta-analysis. Perioper Med (Lond). Published 22 July 2024. doi:10.
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