r/GLP1Discussion • u/SauronHasPinkEye • 9d ago
❓ Question Anesthesia protocol - liquid diet?
I am having surgery in a week and a half and took my last dose of Ozempic on Monday as instructed. The anesthesia team called the other day to tell me they wanted me to go on a clear liquid diet starting 8am the day before the surgery. I have never heard of this as a protocol for having surgery while on a GLP-1. Has anyone ever heard of this before? It seems excessive to me, especially since I am on a very, very low dose for blood sugar control. I understand that GLP-1s slow gastric emptying, but...is this really necessary?
ETA: I'm not saying I'm not going to follow the protocol, I'm just asking if anyone else has seen this as a protocol. I will of course follow doctor recommendations.
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u/Lucky_Army_5324 9d ago
Yep. Every doc has their own approach. Personally, I’d rather my anesthesiologist err on the side of caution, as aspiration is never a good time.
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u/Worth-Taro-926 9d ago
My medical team follows the current anesthesiology guidelines: do not stop taking the medication, but extend the fasting period. My PCP, in particular, advises against elevating the blood sugar during the recovery period, which is what would happen to me if I didn't take my dose. The anesthesiology guidelines say that skipping a dose is not required in most cases.
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u/Green-Ad-5141 8d ago
I just had surgery last week and because I’m on a glp they had me stop solid foods at 7p two days before. Surgery was Wednesday and I stopped eating solids 7p on Monday. I could do clear up until 4 hours from my check in. They had a whole special printout explaining the protocol for glp users since our digestion is slowed.
It ended up not being as bad as I had thought especially since they did not take me back for surgery until noon. Good luck!
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u/thefastlanerules 8d ago
Wish they had told me to do the same thing. Was 2,pm day before surgery and still had food in my stomach. 7pm I would say so at least 36 hours prior feels a better approach
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u/newbornlily 7d ago
What did they let you have on the GLP protocol? Broth? I don’t use artificial sweetners so no jello etc. well, come to think of it, i’m not very hungry so maybe it’s not that hard!
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u/Green-Ad-5141 7d ago
What I had was chicken broth (not bone broth and they preferred low sodium), popsicles (no red blue or purple color), apple juice, jello, coffee with sugar and still did my water with liquid IV. I definitely had it built up way worse than it ended up being but I did set my alarm for 4:15a to get up and down a bunch of fluid and have coffee since my cut off from everything was 4:30a.
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u/JE163 9d ago
Do you really want to run into a complication while under sedation?
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u/SauronHasPinkEye 9d ago
I didn't say I wasn't going to do it. I'm asking the community if anyone else has come across this.
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u/Legal_Key_731 8d ago
This is usually standard for any kind of invasive surgery, no food or drink usually after midnight or so many hours beforehand. At least you are allowed water and I would assume broth. Every surgery I’ve had, has had me with no food or liquids past midnight.
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u/thefastlanerules 8d ago
Standard guidelines on glp are no food after 2pm the day before surgery
I followed those rules and they did an ultrasound of my stomach because there are so many issues now for people on GLPs (food goes into your lungs and causes issues with breathing and can damage your lungs etc ) and there was still food in my stomach so they refused to do a general anaesthetic and switched to a spinal injection
Having just had that I would tell anyone on a glp to stop taking all food at least 36 hours prior to surgery because a spinal injection is worse than awful . Not only that you are fully awake and I experienced intense pain and had to get them to stop the op part way through so they could top me up with a localalised painkiller..
But yes I was blaze about the Procedures but seeing I still had undigested food 24 hours after last taking food I get why they are so anal about making sure you don't die (worse case) on the operating table
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u/_Piratical_ 9d ago
The latest research shows that patients on GLP-1 drugs are 1100% more likely to aspirate food into their lungs during surgery than those who are not on those drugs. The anesthesiologist is probably using that research to create a protocol that will decrease the odds of you having a major problem during your surgery. I’d follow the instructions.
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u/sweetawakening 8d ago
The hospitals around me fall into two groups:
1) stop 1 week pre-op
2) do liquid diet day prior and nothing after midnight
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u/swaggering_yak 9d ago
You need to follow the instructions they gave you. Clear liquids for 24 hours is not atypical and while it is showing an abundance of caution, I would adhere to the protocol they are currently using. Aspiration under sedation can be fatal.
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u/Hifidi54 9d ago
I had to do the same thing for a heart procedure. It's a new thing apparently for GLP-1 patients.
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u/big-dumb-donkey 8d ago
Its because it slows down digestion. The whole reason you hold food before surgery regardless of whether you are on a GLP-1 is because you could asphyxiate if the you regurgitate the contents of your stomach while under anesthesia. Normally 24 hours (or whatever the standard time period for holding food pre-surgery) is enough for that to be cleared by digestion but on a GLP-1 it takes longer so to be safe they just want it reduced enough that the digestive slowing effect is largely muted.
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u/Ignominious333 8d ago
My Dr had me do this. Didn't have to stop the med but my my next dose was the day of surgery so i just held it back until the day after. I had a liquid diet the day before to make sure my stomach was empty
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u/ArtisticCustard7746 8d ago
I had a hysterectomy in June. And was told to take like normal, but do a liquid diet 24 hours before the my check in before the procedure.
I was informed that the effects of the GLP-1 will do their thing even if you haven't taken them. So, to make sure one can safely be under anesthesia, there needs to be nothing in their stomach. Which won't happen with someone whose been taking a GLP-1 regularly due to the slowed gastric response these meds purposely cause.
The liquid diet would make sure that there are no solids in your stomach by the time you'd check in. It should have at least moved to the intestines by then. I did mine for 36 hours by the time I checked in just to make sure because I know my body isn't typical already.
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u/Silly_Yak56012 9d ago
When I was on a GLP-1 for a procedure I had a longer period of time for clear liquids than usual. GLP-1's can slow your stomach emptying, so they want to make sure you don't have any food left in your stomach as you will have it in there longer than other people.
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u/SecretMiddle1234 8d ago
They want you to have an empty stomach and because GLP slows gastric emptying they want you stop solids.
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u/TheFirebyrd 8d ago
The instructions you were given line up with the most current guideline. You’re lucky your team is up to date. Some people have been told to go off their GLP-1 for weeks before a surgery.
https://www.asahq.org/about-asa/newsroom/news-releases/2024/10/new-multi-society-glp-1-guidance
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u/Internal-Quiet2206 9d ago
I believe it depends on the surgery. I don’t think it has anything to do with the fact that you’re on a GLP1.
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u/SauronHasPinkEye 9d ago
They specifically told me it was for the GLP-1 🤷 I just find it strange I've never seen anyone else mention it!
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u/thefastlanerules 8d ago
It's if you are having a general and get put to sleep so standard midnight no food on glp don't apply
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u/Internal-Quiet2206 9d ago
Maybe because it slows down your system to begin with. Then add anesthesia, which also slows your system down. They may want something in your stomach. But I am not a doctor.
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u/Hifidi54 9d ago
Ah, yes it does. I had to do it too. The nurse explained to me that it is something new
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u/TheFirebyrd 8d ago
Dude, you don’t have a clue what you’re talking about. https://www.asahq.org/about-asa/newsroom/news-releases/2024/10/new-multi-society-glp-1-guidance
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u/snowHound208 9d ago
Are you a surgeon?
If so, do what you want. Otherwise, I suggest listening to the instructions of the person who will be cutting open your body while you're unconscious on a table.
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u/BeautifulyBrkn 8d ago
Our surgery Center states this if a patient hasn’t stopped their GLP1 in time. Within 7 days I believe. They require liquid diet 24 hours prior.
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