Perioperative management of patients taking glucagon-like peptide 1 receptor agonists: Society for Perioperative Assessment and Quality Improvement (SPAQI) multidisciplinary consensus statement

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Abstract

The perioperative management of patients using glucagon-like peptide 1 receptor agonists remains a topic of debate. While several multisociety statements have been published recently, the recommendations vary significantly in terms of medication management and preoperative fasting protocols for these patients. This document represents a multidisciplinary consensus statement led by the Society for Perioperative Assessment and Quality Improvement (SPAQI). It provides updated recommendations based on a modified Delphi process and supported by a systematic review of the current literature. The recommendations address management of the glucagon-like peptide 1 receptor agonists perioperatively, and preoperative fasting times for both solids and liquids. Systematic review protocol: PROSPERO (CRD42023438624).

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Oprea, A. D., Ostapenko, L. J., Sweitzer, B. J., Selzer, A., Irizarry-Alvarado, J. M., Hurtado Andrade, M. D., … Hepner, D. L. (2025). Perioperative management of patients taking glucagon-like peptide 1 receptor agonists: Society for Perioperative Assessment and Quality Improvement (SPAQI) multidisciplinary consensus statement. British Journal of Anaesthesia, 135(1), 48–78. https://doi.org/10.1016/j.bja.2025.04.001

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