服用类似葡萄糖-1受体激动剂的患者的术后管理
Glenio B Mizubuti1, Anthony M-H Ho1, Leopoldo Muniz da Silva2
1Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston Health Sciences Centre, Kingston, Ontario, Canada.
Current opinion in anaesthesiology
|February 23, 2024
概括
类似葡萄糖类-1受体激动剂 (GLP-1-RAs) 可能会增加由于胃排空延迟而引起的支气管吸收风险. 临床医生应遵循麻醉学会关于术后GLP-1-RA管理的指导方针.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
- 胃肠病学 胃肠病学
背景情况:
- 葡萄糖类-1受体激动剂 (GLP-1-RAs) 越来越多地用于2型糖尿病和肥胖症.
- 众所周知,这些药物会延迟胃空化,这是与外科手术期间风险相关的因素.
- 新出现的证据表明GLP-1-RA使用与术后并发症之间存在潜在联系.
研究的目的:
- 审查GLP-1-RAs的作用机制,临床结果和术后影响.
- 专注于支气管吸收风险和当前的管理建议.
- 确定对外科手术期间GLP-1-RA使用的知识差距和未来研究方向.
主要方法:
- 对GLP-1-RAs和外科手术期间管理的现有研究的文献综述.
- 对案例报告和回顾性观察性研究的分析.
- 审查麻醉学会的指导方针和安全公告.
主要成果:
- GLP-1-RAs与延迟的胃排空有关.
- 病例报告和观察性研究表明,随着外科手术期间使用GLP-1-RA,即使在长时间禁食的情况下,支气管吸气的风险也会增加.
- 麻醉学会已经发布了关于外科手术期间GLP-1-RA管理的指导方针和安全警告.
结论:
- 在外科手术期间使用GLP-1-RA与延迟胃空气和更高的支气管吸收风险有关,特别是在全身麻醉或深度镇静下.
- 需要进行高质量的研究,以根据药物,剂量和患者因素确定最佳的手术前戒药时间和禁食间隔.
- 临床医生必须意识到这些风险,并遵守当前麻醉学会关于术后GLP-1-RA管理的建议.
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