INTERFERENCE OF GLP-1 AGONISTS IN GENERAL AND DENTAL ANESTHESIA: AN ANALYSIS OF OZEMPIC

Abstract

Objective: The aim of this narrative review of the literature is to address the potential difficulties faced by patients using glucagon-like peptide-1 (GLP-1) agonists during procedures under general and dental anesthesia, with an emphasis on the clinical and pharmacological implications of these medications in the anesthetic context. Methodology: For data collection, searches were performed in electronic databases, including PubMed, PROSPERO, SciELO, The Cochrane Library and ScienceDirect, in addition to using Google Scholar as a complementary tool. The search terms used involved combinations of "GLP-1 agonists", "general anesthesia", "dental anesthesia", "perioperative management", and "complications". Results: The studies analyzed indicate that the use of GLP-1 agonists, such as liraglutide, semaglutide and dulaglutide, may be associated with gastrointestinal adverse effects, such as nausea, vomiting and gastroparesis. These effects can directly interfere with preoperative fasting and gastric emptying, increasing the risk of pulmonary aspiration during general anesthesia. Furthermore, during dental procedures, there are reports of hypoglycemia in poorly monitored diabetic patients, especially when there is prolonged fasting associated with the use of insulin or other antidiabetics. The literature also highlights the need for adjustment or temporary suspension of medication before elective surgical procedures, since there are still no standardized protocols, and individualized evaluation is recommended. In the dental context, glycemic control and coordination between the medical and dental teams are essential to minimize intraoperative and postoperative risks. Conclusion: The use of GLP-1 agonists represents an important advance in the glycemic control of patients with type 2 diabetes, but their continued use has relevant implications for anesthetic management, both general and dental. The presence of gastroparesis, increased risks of aspiration, and metabolic alterations reinforce the need for rigorous and multidisciplinary preoperative evaluation.