Amidst differing opinions on the pre-surgery use of GLP-1 drugs like Ozempic and Mounjaro, Florida-based spine surgeon Dr. Alfred Bonati offers a cautious approach. Dr. Bonati, founder of the Bonati Spine Institute and a pioneer in conscious IV sedation, recommends that patients taking GLP-1s should cease their use weeks before any surgical procedure.
This recommendation stems from the fact that GLP-1s slow digestion to aid weight loss, potentially leaving gastric contents in the stomach even after the standard pre-surgery fasting period. This could increase the risk of complications like aspiration during general anesthesia.
“Extra weight puts pressure on the spine and could lead to more medical problems. But doctors have to be very careful with drugs like Ozempic, and should be advising patients to stop using the drug and others like it well before surgery,” said Dr. Bonati.
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At the Bonati Spine Institute, this problem is alleviated because Dr. Bonati does not use general anesthesia on his patients.
Instead, he uses only local anesthesia to make the incisions for his minimally invasive surgeries. His patients are put under conscious IV sedation so they remain awake, conscious, and communicative during the entire procedure.
While the usual pre-surgery protocol involves fasting from food, drink, and medication the night before, Dr. Bonati’s experience with over 80,000 procedures using conscious IV sedation has led him to prioritize patient safety above all else.
The use of conscious IV sedation, pioneered by Dr. Bonati and now adopted by some other surgeons, eliminates the need for general anesthesia, thereby potentially mitigating the risks associated with GLP-1 use.
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However, even with this alternative approach, Dr. Bonati’s recommendation highlights the need for careful consideration and personalized consultation between patients and their doctors to ensure the safest possible surgical experience.
“Ultimately, if you are taking a drug like Ozempic, you should be very cautious of being given general anesthesia during a surgical procedure,” he said. “At my practice and with my technique, we are fortunate to not have to worry about this issue. In many cases, people who are told by other doctors that they are too heavy to have surgery come to us because we don’t use general anesthesia. If that is your case, we would love for you to reach out before taking drastic measures like using GLP-1 drugs to lose weight rapidly so you can get the surgery you need.”
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