The impact of Glucagon-like peptide-1 receptor agonists (GLP-1RAs) on anesthetic risk in patients undergoing surgery or esophagogastroduodenoscopy: A systematic review and meta-Analysis

The impact of Glucagon-like peptide-1 receptor agonists (GLP-1RAs) on anesthetic risk in patients undergoing surgery or esophagogastroduodenoscopy: A systematic review and meta-Analysis | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 31 December 2025 V1 Latest version Share on The impact of Glucagon-like peptide-1 receptor agonists (GLP-1RAs) on anesthetic risk in patients undergoing surgery or esophagogastroduodenoscopy: A systematic review and meta-Analysis Authors : Xiaoyu Chen , Pengxiang Zhou 0000-0003-1208-8217 , Wen Yang , Jing Zhang , Jingnan Yang , and Xiaoxiao Li 0000-0002-9158-9556 [email protected] Authors Info & Affiliations https://doi.org/10.22541/au.176719154.49976277/v1 122 views 94 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are known to delay gastric emptying, which has raised concerns about their safety during the perioperative period. This systematic review assesses the association between GLP-1RAs exposure and anesthetic-related adverse outcomes in patients undergoing surgery or esophagogastroduodenoscopy (EGD). Methods: In accordance with PRISMA guidelines, we conducted a systematic search of PubMed, Embase, the Cochrane Library, CNKI, WanFang Data, and SinoMed from their inception until August 31, 2025. The search encompassed RCTs and cohort studies that examining the impact of GLP-1RAs on anesthetic risk in patients undergoing surgery or EGD. The primary outcomes were incidence of aspiration events and the presence of residual gastric content (RGC). Two reviewers independently extracted the data, and we conducted the meta-analysis using a random-effects model. Results: A total of 21 cohort studies involving 275,282 patients were included. The meta-analysis indicated that preoperative exposure to GLP-1RAs was associated with a significantly higher risk of RGC compared with non-use (OR 5.11,95% CI 3.67-7.11, P<0.00001, I 2 =66%). However, there was no statistically significant difference in the incidence of aspiration events between the two groups (OR 1.03, 95% CI 0.87-1.23, P=0.70, I 2 =0%). Conclusion: The use of GLP-1RAs prior to procedures is associated with increased RGC and higher rates of aborted procedures, though not with significantly elevated the risk of aspiration. Our findings inform the preoperative management of GLP-1RAs, supporting discontinuation in elective settings and underscoring the need for prospective studies to strengthen evidence-based guidelines. Supplementary Material File (manuscript.docx) Download 177.80 KB Information & Authors Information Version history V1 Version 1 31 December 2025 Copyright This work is licensed under a Non Exclusive No Reuse License. Authors Affiliations Xiaoyu Chen Peking University Third Hospital View all articles by this author Pengxiang Zhou 0000-0003-1208-8217 Peking University Third Hospital View all articles by this author Wen Yang Peking University Third Hospital View all articles by this author Jing Zhang Peking University Third Hospital View all articles by this author Jingnan Yang Peking University Third Hospital View all articles by this author Xiaoxiao Li 0000-0002-9158-9556 [email protected] Peking University Third Hospital View all articles by this author Metrics & Citations Metrics Article Usage 122 views 94 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Xiaoyu Chen, Pengxiang Zhou, Wen Yang, et al. The impact of Glucagon-like peptide-1 receptor agonists (GLP-1RAs) on anesthetic risk in patients undergoing surgery or esophagogastroduodenoscopy: A systematic review and meta-Analysis. Authorea . 31 December 2025. DOI: https://doi.org/10.22541/au.176719154.49976277/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . Format Please select one from the list RIS (ProCite, Reference Manager) EndNote BibTex Medlars RefWorks Direct import Tips for downloading citations document.getElementById('citMgrHelpLink').addEventListener('click', function() { popupHelp(this.href); return false; }); $(".js__slcInclude").on("change", function(e){ if ($(this).val() == 'refworks') $('#direct').prop("checked", false); $('#direct').prop("disabled", ($(this).val() == 'refworks')); }); View Options View options PDF View PDF Figures Tables Media Share Share Share article link Copy Link Copied! Copying failed. 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