20 August 2023
Doctors who practice anesthesiology in the United States and Canada are expressing concern about patients who take popular weight loss drugs leading up to surgery.
Anesthesiologists work together with surgeons to make sure their patients are asleep, or sedated, before medical procedures.
More and more people are taking the weight loss drugs Ozempic and Wegovy. Anesthesiologists say they are having trouble deciding when surgeries should take place.
That is because the weight loss drugs cause people to hold food in their stomachs longer than usual.
People who still have food in their stomachs when they are put to sleep before surgery risk a complication known as a pulmonary aspiration. That is that is the term for when someone breathes some of their stomach contents into their lungs. In extreme cases, the food particles can cause infection or even death.
Most patients are told to not eat for about eight hours before surgery. However, the doctors say those guidelines may need to be changed for patients who are using the weight loss drugs.
Ion Hobai is an anesthesiologist at Massachusetts General Hospital in Boston. He said everyone who takes the drugs should know about "such a serious sort of potential complication."
Komodo Health is a technology company that works in healthcare. According to its research, nearly 6 million prescriptions for the weight loss drugs were written in the first five months of 2023.
In June, the American Society of Anesthesiologists said patients should not take daily weight loss medications on the day of surgery. It also advised that patients should not get their weekly weight loss injection for a week before any sedation procedures.
Dr. Michael Champeau is the head of the organization. He said the recommendation is based on experiences from anesthesiologists around the United States.
A group of anesthesiologists, including Hobai, said they would recommend even more time off from the drugs before surgery. In the Canadian Journal of Anesthesia, they suggested about three weeks.
Dr. Philip Jones is an anesthesiologist at the Mayo Clinic in Minnesota. After three weeks, he said, the drug should no longer be affecting the stomach. At that point, he said, "everything should go back to normal."
Hobai said he is finishing a study of 200 patients who were using drugs such as Ozempic and Wegovy before surgery. He said his results are similar to a smaller study in Brazil that found 25 percent of patients still had food in their stomachs 10 days after stopping the drug.
Because of this information, the American Society of Anesthesiologists said doctors who are unsure of their patients' stomach contents should work differently. They say doctors should work as they would if they knew the patient's stomach was full.
Aspiration only happens one time out of every 2,000 to 3,000 operations that require sedation. But when it does happen, the patients develop a lung injury half the time. That is why the doctors are concerned.
One of Hobai's patients who had been taking Wegovy developed a problem that required serious care. He had not eaten for 18 hours before surgery.
In another case, a woman taking a small amount of Ozempic did not eat for 10 hours before surgery. She was in the middle of a procedure that had to be stopped because doctors saw food in her stomach.
Dr. Elisa Lund is an anesthesiologist at the University of North Carolina in Chapel Hill. She said many doctors have similar stories, as the weight loss drugs have become more common.
"It has exponentially increased," she said.
Novo Nordisk is the drug company that makes Wegovy and Ozempic. The company said there was nothing in its testing that showed the drug would lead to aspiration. However, the drug-maker did say the medications can cause the stomach to empty more slowly.
Hobai said he is also concerned about patients going off their medications for too long. For example, the drugs are used to control the blood sugar level of patients with diabetes. If they stop taking them before surgery, they may face a different kind of health problem.
He said patients who are using the drugs should tell their doctors about them and discuss the risks of having surgery.
"If you're taking this drug and you need an operation, you will need to have some extra precautions," he said.
I'm Caty Weaver. And I'm Dan Friedell.
Dan Friedell adapted this story for Learning English based on a report by The Associated Press.
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Words in This Story
practice –v. to do something again and again, in this case as a task of employment
surgery –n. medical treatment in which a doctor cuts into someone's body in order to repair or remove damaged or diseased parts
procedure –n. a process or way of doing things, in this case related to a medical task done by a doctor
complication –n. a way of speaking about a problem found after a medical procedure such as a surgery
potential –n. the possibility of something happening in the future
prescription –n. a written order by a doctor that permits a person to hold and use a medication
exponentially –n. a way of discussing something that grows at a high rate, or higher than usual
precaution –n. taking extra care to prevent a problem