Use of GLP-1 agonists prior to THA may increase postoperative nausea, vomiting
Key takeaways:
- Postoperative nausea and vomiting occurred in 18.2% of patients prescribed GLP-1s vs. 6% of patients in a matched cohort.
- Protocols should be established to reduce nausea and vomiting in patients on GLP-1s.
SAN DIEGO — GLP-1 agonists may lead to increased nausea and vomiting in the early postoperative period after total hip arthroplasty, according to results presented here.
“Orthopedic surgeons need to be cognizant of patients on GLP-1 agonists and council them that they may experience more postoperative nausea and vomiting than patients not taking the medication,” Sara E. Strecker, PhD, research scientist at the Bone & Joint Institute of Hartford HealthCare, told Healio.
Strecker and colleagues retrospectively reviewed data from patients who underwent primary, unilateral THA for osteoarthritis between June 2016 and December 2022. Strecker said 66 patients prescribed GLP-1 agonists for weight loss prior to surgery were matched for sex, age and BMI to 126 patients not prescribed GLP-1s.
“The study was done before any recommendations were adopted specific to GLP-1s and when to stop the medication prior to surgery,” Strecker said in her presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.
Strecker said 18.2% of patients prescribed GLP-1s had postoperative nausea and vomiting vs. 6% of patients from the matched cohort. She added half of the patients in the GLP-1 group who returned to the ED for further treatment after their index procedure returned due to gastrointestinal complaint.
Neither cohort had aspiration events and there were no significant differences in patient-reported outcomes using the Hip Disability and Osteoarthritis Outcome Score for Joint Replacement, according to Strecker.
Based on these results, Strecker said their institution made changes to the preoperative instructions for patients taking GLP-1 agonists prior to THA. Where patients were previously instructed to not stop their GLP-1 medication and to fast from midnight the night before surgery, she said patients taking GLP-1 agonists are now instructed to consume clear liquids for 24 hours prior to surgery.
“We want to see if our current protocol is decreasing postoperative nausea and vomiting in this patient population,” Strecker told Healio. “If not, we want to see how we can moderate our protocols so that the patient undergoing a total hip arthroplasty who is also taking a GLP-1 agonist can have the most ideal experience possible for their surgery.”
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Magaldi RJ, et al. Paper 350. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 10-14, 2025; San Diego.
