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GL1MPSE
GL1MPSE
GLP-1/GIP receptor agonists in UK surgical patients: a prospective observational multicentre service evaluation
GLP-1/GIP receptor agonists in UK surgical patients: a prospective observational multicentre service evaluation
STAR - Severn Trainee Anaesthetic Research
STAR - Severn Trainee Anaesthetic Research
Chief Investigator: Dr Kariem El-Boghdadly
GLIMPSE is a service evaluation exploring the risks associated with preoperative use of GLP-1/GIP RAs for patients undergoing elective and emergency procedures within NHS trusts in the UK. Adult patients established on a GLP-1/GIP RAs and undergoing a procedure requiring the care of an anaesthetist will be eligible for enrolment into the study, over a 14 day period.
Primary outcomes
To determine the proportion of patients undergoing elective or emergency procedures taking GLP-1/GIP RAs preoperatively
Secondary outcomes
To describe the airway management techniques used for patients established on GLP-1/GIP RAs
To measure the incidence of perioperative dysglycaemic episodes in patients established on GLP-1/GIP RAs
To measure the incidence of pulmonary aspiration in patients established on GLP-1/GIP RAs
To describe local hospital guidelines regarding the management of GLP-1/GIP RAs and compliance with these guidelines
You can find more information here.
Summary of results
Summary of results
Across 119 UK hospitals, 1348/47,039 patients (2.9%) reported GLP-1 use within the preceding three months. Tirzepatide (70%) and semaglutide (26%) predominated.
Peri-operative management varied, with 30% advised to stop treatment, usually withholding it for 8–14 days. Among users undergoing general anaesthesia, 27% received RSI; gastric ultrasound was used in only 1.3% of users overall.
Regurgitation and/or aspiration was more frequent in GLP-1 users, occurring in 19/1348 (1.41%) versus 57/45,691 (0.12%); OR 11.39 (95% CI 6.47–20.05; p<0.001).
Most events involved regurgitation without aspiration. Pulmonary aspiration itself occurred in 2/1348 users (0.15%) versus 16/45,691 non-users (0.035%). Seventeen of the 19 events in users involved regurgitation alone.
Most events occurred during emergence (10/19; 53%), compared with three at induction and five during maintenance; timing was missing for one.
The association does not establish causation. The analysis accounted for hospital site but not patient-level confounders such as obesity or diabetes. Reporting bias was possible, and the study does not establish whether withholding treatment reduces risk.
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