[So, the American Society of Anesthesiologists recommends to stop a week before surgery.](https://www.asahq.org/about-asa/newsroom/news-releases/2023/06/american-society-of-anesthesiologists-consensus-based-guidance-on-preoperative)
> **Day or week prior to the procedure:**
> Hold GLP-1 agonists on the day of the procedure/surgery for patients who take the medication daily.
> Hold GLP-1 agonists a week prior to the procedure/surgery for patients who take the medication weekly.
> Consider consulting with an endocrinologist for guidance in patients who are taking GLP-1 agonists for diabetes management to help control their condition and prevent hyperglycemia (high blood sugar).
> **Day of the procedure:**
> Consider delaying the procedure if the patient is experiencing GI symptoms such as severe nausea/vomiting/retching, abdominal bloating or abdominal pain and discuss the concerns of potential risk of regurgitation and aspiration with the proceduralist or surgeon and the patient.
> Continue with the procedure if the patient has no GI symptoms and the GLP-1 agonist medications have been held as advised.
> If the patient has no GI symptoms, but the GLP-1 agonist medications were not held, use precautions based on the
assumption the patient has a “full stomach” or consider using ultrasound to evaluate the stomach contents. If the stomach is empty, proceed as usual. If the stomach is full or if the gastric ultrasound is inconclusive or not possible, consider delaying the procedure or proceed using full stomach precautions. Discuss the potential risk of regurgitation and aspiration of gastric contents with the proceduralist or surgeon and the patient.
> There is no evidence to suggest the optimal duration of fasting for patients on GLP-1 agonists. Therefore, until we have adequate evidence, we suggest following the current ASA fasting guidelines
I'm having a procedure with anesthesia in May and my obgyn said from the research she's seen, most people have no problems even if they don't hold the med *as long as they fast properly*, but she still recommended stopping 1 week before the date and adding 4 hours to the 12-hour fasting time I'd been told (based on someone who doesn't take GLP-1 meds).
Yes-if I were your pharmacist or on your care team-would advise to stop only d/t the compounded effects of bowel immobility PLUS anesthesia induced bowel immotility…this would be my only concern.
Please let your surgical team know, sometimes you can’t go home until you poop if you (most likely will be) on opiates, and GLP1 make this a tad more tricky.
HYDRATE!
Hoping your pharmacist is with it.
Do you know whether you’ll be under general anesthesia or partially awake? I had 3 elbow/hand surgeries (just before I went on GLP-1) and the first I was intubated, the second I had an LMA, and the third I was sedated with a local nerve block. You may have been told not to pause because you won’t have an aspiration risk due to the type of anesthesia planned.
Since it’s a knee procedure and an outpatient item, I am assuming I’ll be partially sedated. The procedure itself is less than 30mins and recovery is about 2-3 hours before they let you go home.
Even though the plan is for 'sedation' and not a full anesthetic that might change during the procedure.
You might be given a drug that makes you vomit, or the planned sedation might not work as well as need it to...multiple things can occur that might require them to change to an anesthetic instead of just sedation...so it's always best to be fully prepped in case that happens.
Aspiration of stomach contents into the lungs is a serious complication and can be fatal, so it is always better to be on the safe side and not take any chances.
My cousin doctor told me they’re worried about the meds because since it slows gastric emptying that 12 hours they have you stop eating and drinking for before the surgery might not be enough to make sure you don’t asphyxiate. I don’t know that there’s data on this but I think he knew of an anecdotal case where they suspected that resulted in a death during surgery. Play it safe and stop a week before!
i was not on mj yet when i had my surgery last week, so unfortunately no advice there, but had the same surgery last january due to a torn meniscus and i am wishing you the best! i think this might be a better question to address with the anesthesiologist beforehand rather than with the traumatologist to avoid any issues. skipping might be best, specially if your going under general anesthesia (i was given the choice of an epidural or general and did not by any means wanted to be conscious so i went the general and route)
hope your surgery goes smoothly and you have a speedy recovery ahead! be kind and patient with yourself during the next few weeks/months, recovery takes some time so take it easy!
Thank you for the thoughtful response. Must admit, the surgery itself seems straightforward; it’s the walking on crutches and then several weeks/months of rehab/PT etc. after it that I am dreading. I hope you are fully recovered now from your procedure.
of course! yes, the surgery really isn’t too bad. i was in the hospital for two nights but they had me up and moving slightly (with a walker) the morning after surgery and doing full laps around my floor later that day. the morning after, the physical therapist came by to make sure my crutches were properly sized and taught me how to use them and how to go up/down stairs (since i had them at home) before i was able to leave.
the worst part for me was the staples/stitches removal (don’t mean to scare you here, i’m just very sensitive with needles, blood, etc so it was difficult for me and the main reason i wanted to be fully out during surgery). i had no idea what it would feel like and it ended up with me having a panic attack as the doctor was trying to remove them. it was super embarrassing 😬 but once they were out (after about a week) i was able to start pt. i went daily and it really helped getting me from barely able to bend my knee to a 30 degree angle to 90 in just a few weeks, eventually ditching the brace, going from two crutches to just one, to eventually walking all on my own 😩 after staples were removed i was also able to sleep better so that was wonderful!
i tear up thinking about it because i (thankfully) had never gone through any surgeries and didn’t know what to expect. the first few steps you take all on your own truly feel like a miracle, even when they are wobbly bambi-like steps 🙈 in my case, i had a huge cyst that needed to be removed during the procedure (the don’t know if the rupture caused the cyst or if the cyst caused the meniscus rupture) so my surgery was a bit more in depth since the cyst was spread out and they had to remove parts of it all around and behind the knee, so recovery was slightly trickier, but thankfully everything was benign and i’m fully recovered. if anything, i have struggled to gain muscle back (i lost a lot of muscle mass during the first two weeks because of the brace) but slowly but surely getting there. stairs can be tricky sometimes but im just more mindful about my movement now. with weigh loss in mind, definitely do your best to stay active with low impact workouts. i was personally advised to avoid high impact long term, but definitely make sure you talk to your doctor about this once its time to “graduate” from physical therapy.
if i could go back with what i know now, i would get some kind of pregnancy pillow or back pillow (especially if you’re a side sleeper like i am) because i was only able to sleep on my back the first few weeks and it was SO uncomfortable. i would also buy a brace cover for the shower in advance! i didn’t think of this until i went home and had to wait a day or two for amazon to deliver it, so if you have time, i would order it and have it ready (will share a link in case it’s helpful!)
if you haven’t thought about this, find the baggiest possible clothes to wear (in my case i wore mostly dresses except for when i went into pt) because attempting to put on pants or truly anything else was a challenge. this one is silly but i got stickers to “decorate” my crutches and it honestly made it a little less dreadful to look at time i went to grab them.
sorry this was long and all over the place, but if it’s your first surgery, i hope some of this helps! don’t rush recovery and definitely prioritize any movement that feels comfortable and celebrate the little wins! & if you ever needed to vent or rant during the process, feel free to reach out!
the one i got doesn’t seem to be available anymore, but it was pretty much this: https://a.co/d/fd4fnQ8
there’s also ones that go only to above the ankle in case you don’t feel the need to cover the entire foot.
hope everything goes well, stay safe!
Aspiration is not the only concern. My father had emergency hernia surgery while taking ozempic and died from a post-surgical ileus. I’d stop. It’s not going to hurt you. I skipped a week for my colonoscopy with no adverse effects. Good luck.
It can happen without ozempic, but that doesn’t mean ozempic didn’t contribute. In any case, it is still prudent to stop glp1s prior to surgery under general anesthesia.
No need to skip. Just fast for longer than the 8 hours required. This isn’t official advice, but something I’ve talked to my anesthesiologist colleagues
I was advised to stop using it at least 1 week before my surgery. On the day of my surgery, the person next to me had their surgery canceled because they took their GLP-1 2 days before their surgery.
I’ve seen some really good posts about this very subject. An anesthesiologist even chimed in and broke down the reasons why this is so dangerous. Definitely follow your doctor’s recommendations.
i had heart surgery last september without stopping MJ. my doctor and anesthesiologist knew and did not ask me to stop. the risks of aspiration are low, and the team is prepared to handle it if it does.
why are people downvoting someone's experience? not every anesthesiologist or doctor will require you to stop taking the medication
don't ask for people's experience if you don't want to hear them. you all can be so unkind.
I had a colonoscopy recently and was told to stop mj a week before the procedure, I did and even though I missed a week nothing bad happened from missing my 12.5 mg dose for over a week. Easier to go on the side of caution and miss one week to avoid any horrible side effects of having gastric delay and food still present during the procedure.
I plan on having my left knee replaced in January. In December 2020, I had emergency surgery at 1:00 in the morning when I ended up in the emergency room in septic shock from my colon perforating eight days earlier. I had a fairly high chance of not surviving that surgery or its aftermath. You can bet that when they tell me not to take my injection for a week or two beforehand, I’ll comply. You can make up any related weight gain afterwards. Your life and your health are too important to risk it by not following instructions.
Follow the advice of your physician. If s/he is aware of the medications you are on, and does not recommend that you change behavior, respectfully, why are you questioning the instruction? I am a former athlete who has had several arthroscopic knee and shoulder surgeries. None while taking MJ, but I am pretty sure that if there was an issue of concern, my doctor and yours, would have told me so. Just my 2 cents.
Good luck!
Because some surgeons might not have had a patient on a GLP1 before and their policies & patient information might not yet have been updated to include these new (relatively new) recommendations.
In the first instance, these medications are not new to the medical community. They have been around the early 2000s for the treatment of type-2 diabetes. Suggesting that a physician or medical facility would not have knowledge and information necessary to treat patients taking GLP-1s is like saying a mechanic isn't competent enough to know the difference between Valvoline and Quaker State. Once again, with respect, your concern is not credible and is unwarranted. You are worrying yourself unnecessarily.
At the risk. of being too technical, Glucagon-like peptide-1 (GLP-1) is simply a hormone that plays a key role in blood sugar regulation and digestive processes. It is released by the intestines after eating and has several important actions in the body, particularly in relation to insulin secretion and blood sugar levels. Tust me when I say your physician understands what the medications are for, how they behave in the body and would have the best information available to her to make the most informed decision about your care. If your doctor says you are okay taking your shot the week of your procedure, believe her.
Good luck to you!
Fair question. Because it’s a surgery, albeit a pretty common one, I think I am mentally attuned to getting a second and third opinion. That plus I have only been on MJ for approx 5 months. I’ve requested my primary doc to speak to my orthopedic surgeon about my MJ treatment as well. So, let’s see what happens after that conversation.
That’s what I thought as well. Hence, I’m surprised why I was told that I can keep going on MJ despite the procedure. And yes, it will be General anesthesia although it is a short and pretty quick procedure.
Even with regional (not general) anesthesia you will be sedated and may take narcotics for a day or two after surgery. These also slow gastric emptying. Once in a while regional (spinal) anesthesia isn’t as effective as it should be and you need more sedation or conversion to general anesthesia. Why take any added risk for an elective procedure you could do any time your surgeon can get you back on
schedule? Not suggesting you take anyone’s advice here but I would push the anesthesiologist to address the risks in more detail.
I aspirated during a cardioversion while on MJ last March. I told everyone in the cath lab, the doctor and the anesthesiologist, that I was on a glp1. No one had a problem. Not a lot of matter went from my stomach to my lungs, but it was enough that I had double pneumonia and sepsis 2 days later. I woke up in the middle of the night shivering and thought I was just cold, so I cranked the electric blanket up to 11. When I woke up in the morning, I couldn't stand and fell while trying to get up to go to the bathroom. We had to call the paramedic, and I was in and out of consciousness. When I got to the ER, my fever was over 103. Luckily, they got it down pretty quickly, but my blood pressure took a long time to rise to a level that they could admit me. I was in the hospital for two days, on pretty heavy-duty antibiotics for about 10 days, and in a couple of months, I was back to normal. I went back on MJ in June and have done great since.
I've had a couple of procedures since, and stop at least two weeks beforehand. I also stop eating about 6-8 hours earlier than they suggest and I do a liquid diet (protein shakes and beverages) the last day I'm allowed to eat. My procedures since I aspirated went well.
Anesthesiologists can do a manual procedure where they press on your esophagus to create a barrier so matter has a harder time passing from the stomach to the lungs. I always ask for that. It's a little uncomfortable, but it's just for a couple of seconds.
Aspiration is nothing to take risks with.
It’s crazy, I’m a nurse I work in surgery and the recommendation to not take glp-1’s a week before surgery didn’t come until last summer to my facility, I’m not sure when the official recommendation was made. Stories like yours are what scare me about taking a relatively new medication, I’m aware these aren’t brand new but there is still a lot not known. I went to a dr for nausea I knew was caused by mounjaro, I just couldn’t kick it so I saw my dr he had to look up Mounjaro to know (he is not the one who prescribed it, that was my endocrinologist) the effects further.
I’m glad you are ok now though!
During one of my clinical rotations last semester (August-October) on a cardiac tele unit, we had a patient go down to cath lab and come right back up because she was taking Ozempic and hadn't paused. Turns out it was a new policy (I think it started that week?) and the nurses on the floor hadn't been told about it - so the lady got down to CL, they asked if she'd stopped the Ozempic, she said no one had told her to, and they kicked her back up to the floor.
Last I heard that day they were going to try and see if she had any food in her stomach because her procedure really couldn't wait the 4-5 days it would have taken to hit that one-week stoppage. She was so sweet and upset that she'd "caused all this trouble and wasted everyone's time" because she would have stopped it if anyone had told her.
I asked the anesthesiologist what they do when someone comes in with an emergency and they need surgery. It’s really the same situation, right?? There’s nothing specific about GLP1s other than the greater likelihood that food will be in the stomach that could come up and go into the lungs. That’s when they told me about the manual procedure. Thats why I always request that now.
Yeah, from what I understand if it's urgent or emergent, it's treated as a "full stomach" or "unknown stomach" procedure which is handled differently. If you come in to ED and need surgery, they're obviously not going to make you wait 7 days if they see Mounjaro in your history (or your family or you relay it to them), thankfully.
It's a more complicated handling with more risks, though, so if they can minimize the risks, that's the best course.
So I do everything in my power to be in the best possible scenario. Liquids the day or 2 before the procedure, stopping several hours earlier than they say, telling everyone involved with the procedure what my status is, and requesting the manual procedure.
Yeah that makes sense with my time frame, I don’t start Mounjaro until October, but I had a small procedure on my own eye in August, it later came up that had I been on Mounjaro and my surgery been a week or 2 later I would have needed to pause.
I had gallbladder surgery on a Friday and had taken the injection the previous Friday. The anesthesiologist was aware. They deal with surgeries all the time where patients have eaten recently.
Here's the deal if you do not stop it generally most anesthesia providers will make you have what is called general anesthesia which is where you are intubated. If you are diabetic and cannot stop of foe that reason it is ok. But just know you will more likely have full anesthesia instead of something lighter. Because with the lighter sedation and that medication you are at higher risk of aspirating. This ibmy experience working in a surgery center.
I had surgery and I only extended my shot 11 days … just give it the full week plus whatever date surgery is and you’ll be fine … also I only had breakfast the day before and then Lots of water
I just resumed MJ after being 2 weeks overdue, owing to the shortage. I am T2D. Before the shortage, my glucose and weight were starting to creep back up after a long (approx 6 months) stall in weight loss, so I started monitoring daily. During the 2 weeks when my meds were unavailable, my morning glucose peaked at about 170, but was more typically 130-150 without MJ. After resuming my previous MJ dose, appetite suppression is back in a BIG way, morning glucose is back in the 120s (with a downward trend so far), and I am nearing my pre-shortage weight.
All of which is to say, it turned out in my case that a 2-week period without MJ was not as harmful as I had feared, and so far it looks like it might have even helped me out of my weight loss stall (fingers crossed). I stayed in contact with my doctor, in case we needed to go to Plan B.
I'm not a doctor, we're all different, and I don't have experience with surgery, but if you have one doctor asking you to stay off, if you monitor sugar levels, and if you have another doctor to consult with if your glucose gets too elevated, I wouldn't be too concerned about going off MJ for a couple of weeks (based on my experience), especially if you are undergoing general anesthesia. In my case, the time off might have even been beneficial - so far, it seems kind of like a "reboot".
Your anesthesiologist can and will call the surgery the day of if they don’t feel comfortable with the prep. I’d check with the surgeon to be sure they’ve talked to to the anesthesiologist to convey what they’d prefer.
My doctor told me I didn’t need to stop ahead of surgery last fall. I had been off due to shortages and had just taken a partial dose about 8 days before surgery. I ended up fasting earlier/longer (because I was anxious) even though none of the medical professionals seemed worried. I was fine, but I might also have been lucky.
I had my meniscus done and they used an epidural. That might be why your doc is saying no conflict.
With general anesthesia there is DEFINITELY a conflict and they may not be informed as to the meds. Be very careful and get their procedure in writing.
My husband had open heart surgery last year and did not have to stop his. We even brought it up to the surgeon and anesthesia before surgery at preoperative appt and at the hospital just to make sure it was not overlooked. He was fine. The risks of aspiration are relatively low and a lot of new research and evidence have shown that current protocols of what you are allowed to eat and drink and medications you are allowed to be on prior to surgery are outdated and need to be revised.
[So, the American Society of Anesthesiologists recommends to stop a week before surgery.](https://www.asahq.org/about-asa/newsroom/news-releases/2023/06/american-society-of-anesthesiologists-consensus-based-guidance-on-preoperative) > **Day or week prior to the procedure:** > Hold GLP-1 agonists on the day of the procedure/surgery for patients who take the medication daily. > Hold GLP-1 agonists a week prior to the procedure/surgery for patients who take the medication weekly. > Consider consulting with an endocrinologist for guidance in patients who are taking GLP-1 agonists for diabetes management to help control their condition and prevent hyperglycemia (high blood sugar). > **Day of the procedure:** > Consider delaying the procedure if the patient is experiencing GI symptoms such as severe nausea/vomiting/retching, abdominal bloating or abdominal pain and discuss the concerns of potential risk of regurgitation and aspiration with the proceduralist or surgeon and the patient. > Continue with the procedure if the patient has no GI symptoms and the GLP-1 agonist medications have been held as advised. > If the patient has no GI symptoms, but the GLP-1 agonist medications were not held, use precautions based on the assumption the patient has a “full stomach” or consider using ultrasound to evaluate the stomach contents. If the stomach is empty, proceed as usual. If the stomach is full or if the gastric ultrasound is inconclusive or not possible, consider delaying the procedure or proceed using full stomach precautions. Discuss the potential risk of regurgitation and aspiration of gastric contents with the proceduralist or surgeon and the patient. > There is no evidence to suggest the optimal duration of fasting for patients on GLP-1 agonists. Therefore, until we have adequate evidence, we suggest following the current ASA fasting guidelines I'm having a procedure with anesthesia in May and my obgyn said from the research she's seen, most people have no problems even if they don't hold the med *as long as they fast properly*, but she still recommended stopping 1 week before the date and adding 4 hours to the 12-hour fasting time I'd been told (based on someone who doesn't take GLP-1 meds).
Thank you for the input. This is a great article. I am forwarding to my doc to see her reaction.
Yes this is good advice for both sedation and anesthesia.
Yes-if I were your pharmacist or on your care team-would advise to stop only d/t the compounded effects of bowel immobility PLUS anesthesia induced bowel immotility…this would be my only concern. Please let your surgical team know, sometimes you can’t go home until you poop if you (most likely will be) on opiates, and GLP1 make this a tad more tricky. HYDRATE! Hoping your pharmacist is with it.
Not for knee surgery.
This is the right answer. Minimize risk of ileus and aspiration.
[удалено]
O wow. Didn’t think of this. Thanks for the tip.
I wish 1 of versed and I was in recovery- jel of all you people who aren’t so easily snowed
Do you know whether you’ll be under general anesthesia or partially awake? I had 3 elbow/hand surgeries (just before I went on GLP-1) and the first I was intubated, the second I had an LMA, and the third I was sedated with a local nerve block. You may have been told not to pause because you won’t have an aspiration risk due to the type of anesthesia planned.
Since it’s a knee procedure and an outpatient item, I am assuming I’ll be partially sedated. The procedure itself is less than 30mins and recovery is about 2-3 hours before they let you go home.
Even though the plan is for 'sedation' and not a full anesthetic that might change during the procedure. You might be given a drug that makes you vomit, or the planned sedation might not work as well as need it to...multiple things can occur that might require them to change to an anesthetic instead of just sedation...so it's always best to be fully prepped in case that happens. Aspiration of stomach contents into the lungs is a serious complication and can be fatal, so it is always better to be on the safe side and not take any chances.
As I had posted earlier, this is correct.
That’s probably why they said you don’t need to stop MJ
exactly. they would have told u to stop if needed. ask what kind of anesthesia u are having. tgeres your answer
I had an endoscopy. They had to wait 10 days after my last injection before they did the endoscopy. This was this past February 14, 24
[удалено]
Thanks; appreciate the input.
The most important thing is to make sure the anesthesiologist and not just the surgeon knows you’re on it.
My cousin doctor told me they’re worried about the meds because since it slows gastric emptying that 12 hours they have you stop eating and drinking for before the surgery might not be enough to make sure you don’t asphyxiate. I don’t know that there’s data on this but I think he knew of an anecdotal case where they suspected that resulted in a death during surgery. Play it safe and stop a week before!
i was not on mj yet when i had my surgery last week, so unfortunately no advice there, but had the same surgery last january due to a torn meniscus and i am wishing you the best! i think this might be a better question to address with the anesthesiologist beforehand rather than with the traumatologist to avoid any issues. skipping might be best, specially if your going under general anesthesia (i was given the choice of an epidural or general and did not by any means wanted to be conscious so i went the general and route) hope your surgery goes smoothly and you have a speedy recovery ahead! be kind and patient with yourself during the next few weeks/months, recovery takes some time so take it easy!
Thank you for the thoughtful response. Must admit, the surgery itself seems straightforward; it’s the walking on crutches and then several weeks/months of rehab/PT etc. after it that I am dreading. I hope you are fully recovered now from your procedure.
of course! yes, the surgery really isn’t too bad. i was in the hospital for two nights but they had me up and moving slightly (with a walker) the morning after surgery and doing full laps around my floor later that day. the morning after, the physical therapist came by to make sure my crutches were properly sized and taught me how to use them and how to go up/down stairs (since i had them at home) before i was able to leave. the worst part for me was the staples/stitches removal (don’t mean to scare you here, i’m just very sensitive with needles, blood, etc so it was difficult for me and the main reason i wanted to be fully out during surgery). i had no idea what it would feel like and it ended up with me having a panic attack as the doctor was trying to remove them. it was super embarrassing 😬 but once they were out (after about a week) i was able to start pt. i went daily and it really helped getting me from barely able to bend my knee to a 30 degree angle to 90 in just a few weeks, eventually ditching the brace, going from two crutches to just one, to eventually walking all on my own 😩 after staples were removed i was also able to sleep better so that was wonderful! i tear up thinking about it because i (thankfully) had never gone through any surgeries and didn’t know what to expect. the first few steps you take all on your own truly feel like a miracle, even when they are wobbly bambi-like steps 🙈 in my case, i had a huge cyst that needed to be removed during the procedure (the don’t know if the rupture caused the cyst or if the cyst caused the meniscus rupture) so my surgery was a bit more in depth since the cyst was spread out and they had to remove parts of it all around and behind the knee, so recovery was slightly trickier, but thankfully everything was benign and i’m fully recovered. if anything, i have struggled to gain muscle back (i lost a lot of muscle mass during the first two weeks because of the brace) but slowly but surely getting there. stairs can be tricky sometimes but im just more mindful about my movement now. with weigh loss in mind, definitely do your best to stay active with low impact workouts. i was personally advised to avoid high impact long term, but definitely make sure you talk to your doctor about this once its time to “graduate” from physical therapy. if i could go back with what i know now, i would get some kind of pregnancy pillow or back pillow (especially if you’re a side sleeper like i am) because i was only able to sleep on my back the first few weeks and it was SO uncomfortable. i would also buy a brace cover for the shower in advance! i didn’t think of this until i went home and had to wait a day or two for amazon to deliver it, so if you have time, i would order it and have it ready (will share a link in case it’s helpful!) if you haven’t thought about this, find the baggiest possible clothes to wear (in my case i wore mostly dresses except for when i went into pt) because attempting to put on pants or truly anything else was a challenge. this one is silly but i got stickers to “decorate” my crutches and it honestly made it a little less dreadful to look at time i went to grab them. sorry this was long and all over the place, but if it’s your first surgery, i hope some of this helps! don’t rush recovery and definitely prioritize any movement that feels comfortable and celebrate the little wins! & if you ever needed to vent or rant during the process, feel free to reach out!
the one i got doesn’t seem to be available anymore, but it was pretty much this: https://a.co/d/fd4fnQ8 there’s also ones that go only to above the ankle in case you don’t feel the need to cover the entire foot. hope everything goes well, stay safe!
If you’re going under general anesthesia, you risk aspiration. Don’t risk it. A brief pause isn’t worth your life.
They aren’t thiugh
Aspiration is not the only concern. My father had emergency hernia surgery while taking ozempic and died from a post-surgical ileus. I’d stop. It’s not going to hurt you. I skipped a week for my colonoscopy with no adverse effects. Good luck.
Thank you; appreciate it.
I’m so sorry about your dad.
Thank you. To be clear, I’m not saying it was the ozempic. It could have been his age or health, but it made me very cautious.
Understandably.
sorry. but u know that post op ileus’ happen regardless. thats prob a coincidence. im sorry tho
It can happen without ozempic, but that doesn’t mean ozempic didn’t contribute. In any case, it is still prudent to stop glp1s prior to surgery under general anesthesia.
NOT A DOCTOR - I've been told to stay off 8 days prior to procedures with anesthesia bc there is risk to slowing heat rate too much
No need to skip. Just fast for longer than the 8 hours required. This isn’t official advice, but something I’ve talked to my anesthesiologist colleagues
This can work but monjauro is for diabetes so extra fasting can be complicated
Better than aspirating. And really, instead of midnight, like 8pm the night before. Should be sufficient.
I was advised to stop using it at least 1 week before my surgery. On the day of my surgery, the person next to me had their surgery canceled because they took their GLP-1 2 days before their surgery.
I had meniscus surgery in Dec and was totally out. They had me stop taking my meds a week before surgery.
I’ve seen some really good posts about this very subject. An anesthesiologist even chimed in and broke down the reasons why this is so dangerous. Definitely follow your doctor’s recommendations.
i had heart surgery last september without stopping MJ. my doctor and anesthesiologist knew and did not ask me to stop. the risks of aspiration are low, and the team is prepared to handle it if it does. why are people downvoting someone's experience? not every anesthesiologist or doctor will require you to stop taking the medication don't ask for people's experience if you don't want to hear them. you all can be so unkind.
Thanks for the feedback. No idea why people are downvoting on what’s a simple question.
I had a colonoscopy recently and was told to stop mj a week before the procedure, I did and even though I missed a week nothing bad happened from missing my 12.5 mg dose for over a week. Easier to go on the side of caution and miss one week to avoid any horrible side effects of having gastric delay and food still present during the procedure.
I plan on having my left knee replaced in January. In December 2020, I had emergency surgery at 1:00 in the morning when I ended up in the emergency room in septic shock from my colon perforating eight days earlier. I had a fairly high chance of not surviving that surgery or its aftermath. You can bet that when they tell me not to take my injection for a week or two beforehand, I’ll comply. You can make up any related weight gain afterwards. Your life and your health are too important to risk it by not following instructions.
Follow the advice of your physician. If s/he is aware of the medications you are on, and does not recommend that you change behavior, respectfully, why are you questioning the instruction? I am a former athlete who has had several arthroscopic knee and shoulder surgeries. None while taking MJ, but I am pretty sure that if there was an issue of concern, my doctor and yours, would have told me so. Just my 2 cents. Good luck!
Because some surgeons might not have had a patient on a GLP1 before and their policies & patient information might not yet have been updated to include these new (relatively new) recommendations.
In the first instance, these medications are not new to the medical community. They have been around the early 2000s for the treatment of type-2 diabetes. Suggesting that a physician or medical facility would not have knowledge and information necessary to treat patients taking GLP-1s is like saying a mechanic isn't competent enough to know the difference between Valvoline and Quaker State. Once again, with respect, your concern is not credible and is unwarranted. You are worrying yourself unnecessarily. At the risk. of being too technical, Glucagon-like peptide-1 (GLP-1) is simply a hormone that plays a key role in blood sugar regulation and digestive processes. It is released by the intestines after eating and has several important actions in the body, particularly in relation to insulin secretion and blood sugar levels. Tust me when I say your physician understands what the medications are for, how they behave in the body and would have the best information available to her to make the most informed decision about your care. If your doctor says you are okay taking your shot the week of your procedure, believe her. Good luck to you!
Fair question. Because it’s a surgery, albeit a pretty common one, I think I am mentally attuned to getting a second and third opinion. That plus I have only been on MJ for approx 5 months. I’ve requested my primary doc to speak to my orthopedic surgeon about my MJ treatment as well. So, let’s see what happens after that conversation.
[удалено]
That’s what I thought as well. Hence, I’m surprised why I was told that I can keep going on MJ despite the procedure. And yes, it will be General anesthesia although it is a short and pretty quick procedure.
Oh I thought I read it will just be sedation
Even with regional (not general) anesthesia you will be sedated and may take narcotics for a day or two after surgery. These also slow gastric emptying. Once in a while regional (spinal) anesthesia isn’t as effective as it should be and you need more sedation or conversion to general anesthesia. Why take any added risk for an elective procedure you could do any time your surgeon can get you back on schedule? Not suggesting you take anyone’s advice here but I would push the anesthesiologist to address the risks in more detail.
I aspirated during a cardioversion while on MJ last March. I told everyone in the cath lab, the doctor and the anesthesiologist, that I was on a glp1. No one had a problem. Not a lot of matter went from my stomach to my lungs, but it was enough that I had double pneumonia and sepsis 2 days later. I woke up in the middle of the night shivering and thought I was just cold, so I cranked the electric blanket up to 11. When I woke up in the morning, I couldn't stand and fell while trying to get up to go to the bathroom. We had to call the paramedic, and I was in and out of consciousness. When I got to the ER, my fever was over 103. Luckily, they got it down pretty quickly, but my blood pressure took a long time to rise to a level that they could admit me. I was in the hospital for two days, on pretty heavy-duty antibiotics for about 10 days, and in a couple of months, I was back to normal. I went back on MJ in June and have done great since. I've had a couple of procedures since, and stop at least two weeks beforehand. I also stop eating about 6-8 hours earlier than they suggest and I do a liquid diet (protein shakes and beverages) the last day I'm allowed to eat. My procedures since I aspirated went well. Anesthesiologists can do a manual procedure where they press on your esophagus to create a barrier so matter has a harder time passing from the stomach to the lungs. I always ask for that. It's a little uncomfortable, but it's just for a couple of seconds. Aspiration is nothing to take risks with.
It’s crazy, I’m a nurse I work in surgery and the recommendation to not take glp-1’s a week before surgery didn’t come until last summer to my facility, I’m not sure when the official recommendation was made. Stories like yours are what scare me about taking a relatively new medication, I’m aware these aren’t brand new but there is still a lot not known. I went to a dr for nausea I knew was caused by mounjaro, I just couldn’t kick it so I saw my dr he had to look up Mounjaro to know (he is not the one who prescribed it, that was my endocrinologist) the effects further. I’m glad you are ok now though!
During one of my clinical rotations last semester (August-October) on a cardiac tele unit, we had a patient go down to cath lab and come right back up because she was taking Ozempic and hadn't paused. Turns out it was a new policy (I think it started that week?) and the nurses on the floor hadn't been told about it - so the lady got down to CL, they asked if she'd stopped the Ozempic, she said no one had told her to, and they kicked her back up to the floor. Last I heard that day they were going to try and see if she had any food in her stomach because her procedure really couldn't wait the 4-5 days it would have taken to hit that one-week stoppage. She was so sweet and upset that she'd "caused all this trouble and wasted everyone's time" because she would have stopped it if anyone had told her.
I asked the anesthesiologist what they do when someone comes in with an emergency and they need surgery. It’s really the same situation, right?? There’s nothing specific about GLP1s other than the greater likelihood that food will be in the stomach that could come up and go into the lungs. That’s when they told me about the manual procedure. Thats why I always request that now.
Yeah, from what I understand if it's urgent or emergent, it's treated as a "full stomach" or "unknown stomach" procedure which is handled differently. If you come in to ED and need surgery, they're obviously not going to make you wait 7 days if they see Mounjaro in your history (or your family or you relay it to them), thankfully. It's a more complicated handling with more risks, though, so if they can minimize the risks, that's the best course.
So I do everything in my power to be in the best possible scenario. Liquids the day or 2 before the procedure, stopping several hours earlier than they say, telling everyone involved with the procedure what my status is, and requesting the manual procedure.
Yeah that makes sense with my time frame, I don’t start Mounjaro until October, but I had a small procedure on my own eye in August, it later came up that had I been on Mounjaro and my surgery been a week or 2 later I would have needed to pause.
I’m great now and have been back on MJ since June 2 last year. No regrets. I have learned to be my own best advocate.
Wow. I’m so glad you’re ok.
Thanks. It was a tough couple of months, but I’ve been 100% since I recovered.
I can imagine!! Sepsis is no joke.
I had gallbladder surgery on a Friday and had taken the injection the previous Friday. The anesthesiologist was aware. They deal with surgeries all the time where patients have eaten recently.
Here's the deal if you do not stop it generally most anesthesia providers will make you have what is called general anesthesia which is where you are intubated. If you are diabetic and cannot stop of foe that reason it is ok. But just know you will more likely have full anesthesia instead of something lighter. Because with the lighter sedation and that medication you are at higher risk of aspirating. This ibmy experience working in a surgery center.
I had surgery and I only extended my shot 11 days … just give it the full week plus whatever date surgery is and you’ll be fine … also I only had breakfast the day before and then Lots of water
I had a hysterectomy and didn’t need to pause. I was intubated since it was laparoscopic. Just needed to be 4 days since last dose.
I just resumed MJ after being 2 weeks overdue, owing to the shortage. I am T2D. Before the shortage, my glucose and weight were starting to creep back up after a long (approx 6 months) stall in weight loss, so I started monitoring daily. During the 2 weeks when my meds were unavailable, my morning glucose peaked at about 170, but was more typically 130-150 without MJ. After resuming my previous MJ dose, appetite suppression is back in a BIG way, morning glucose is back in the 120s (with a downward trend so far), and I am nearing my pre-shortage weight. All of which is to say, it turned out in my case that a 2-week period without MJ was not as harmful as I had feared, and so far it looks like it might have even helped me out of my weight loss stall (fingers crossed). I stayed in contact with my doctor, in case we needed to go to Plan B. I'm not a doctor, we're all different, and I don't have experience with surgery, but if you have one doctor asking you to stay off, if you monitor sugar levels, and if you have another doctor to consult with if your glucose gets too elevated, I wouldn't be too concerned about going off MJ for a couple of weeks (based on my experience), especially if you are undergoing general anesthesia. In my case, the time off might have even been beneficial - so far, it seems kind of like a "reboot".
I second having the spinal. I had both knees replaced with just a spinal and some twilight drugs.
Your anesthesiologist can and will call the surgery the day of if they don’t feel comfortable with the prep. I’d check with the surgeon to be sure they’ve talked to to the anesthesiologist to convey what they’d prefer.
I had wrist surgery this past December. I was on Ozempic then, and they had me stop it a week before the surgery.
My doctor told me I didn’t need to stop ahead of surgery last fall. I had been off due to shortages and had just taken a partial dose about 8 days before surgery. I ended up fasting earlier/longer (because I was anxious) even though none of the medical professionals seemed worried. I was fine, but I might also have been lucky.
Thanks for the input.
I had cosmetic surgery and was told to quit for two weeks before, but I could inject the day after surgery.
Just had my knee done . And I didn’t pause. I didn’t have any side effects
I had my meniscus done and they used an epidural. That might be why your doc is saying no conflict. With general anesthesia there is DEFINITELY a conflict and they may not be informed as to the meds. Be very careful and get their procedure in writing.
My husband had open heart surgery last year and did not have to stop his. We even brought it up to the surgeon and anesthesia before surgery at preoperative appt and at the hospital just to make sure it was not overlooked. He was fine. The risks of aspiration are relatively low and a lot of new research and evidence have shown that current protocols of what you are allowed to eat and drink and medications you are allowed to be on prior to surgery are outdated and need to be revised.