AAOS: Stopping GLP-1 RAs 14 Days Before Surgery Can Minimize Complications

Mar 12, 2025

TUESDAY, March 11, 2025 (HealthDay News) — Stopping glucagon-like peptide-1 receptor agonist (GLP-1 RA) treatment 14 days before total joint arthroplasty can minimize risks for complications, according to a study presented at the annual meeting of the American Academy of Orthopaedic Surgeons, held from March 10 to 14 in San Diego.

Shivan N. Chokshi, M.D., from the University of Tennessee Campbell Clinic in Memphis, and colleagues examined the association between the time of last Ozempic dose and anesthesia complications in patients who underwent total hip or knee arthroplasty from January 2018 to January 2023. Ozempic users were classified based on when they stopped medication before surgery (482, 591, 680, 758, 777, and 706 at 30, 14, seven, five, three, and one day before surgery, respectively; 170 patients continued use through surgery); the control group included 206,005 patients without prior Ozempic use.

The researchers found that stopping Ozempic five days, three days, and one day prior to surgery was an independent risk factor for delayed emergence from anesthesia (odds ratios, 1.59, 1.84, and 2.23, respectively). Stopping seven days prior was a risk factor for aspiration pneumonitis (odds ratio, 1.29), with higher risks seen for stopping five days and one day prior (odds ratios, 2.74 and 2.74, respectively). Last Ozempic dose at seven days prior to surgery was identified as an independent risk factor for conversion to intubation in multivariate logistic regression (odds ratio, 1.39). Last Ozempic dose at five days, three days, and one day prior were independent risk factors for conversion to intubation (odds ratios, 2.09, 4.68, and 6.37, respectively). Patients who continued Ozempic through surgery had the highest risk for complications.

“To minimize risks of delayed emergence from anesthesia, aspiration, aspiration pneumonitis, and conversion to intubation, ceasing GLP-1 RA 14 days before surgery is optimal,” the authors write.

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