Among 196 patients undergoing high-definition lipoabdominoplasty under general anesthesia, those taking semaglutide or tirzepatide (n=98) showed no statistically significant differences from controls in intraoperative respiratory events, hemodynamic instability, or arrhythmias. Recovery metrics — time to awakening, mobilization, and discharge — were comparable, as were rates of postoperative nausea/vomiting, pain scores, and early complications including seroma, infection, delayed wound healing, and hyperpigmentation.
This finding carries real clinical weight because anesthesiologists have grown increasingly cautious about GLP-1 receptor agonist users, particularly around delayed gastric emptying and aspiration risk — a concern prominent enough that the American Society of Anesthesiologists issued 2023 guidance recommending drug holds before elective procedures. This retrospective Italian cohort challenges the assumption that GLP-1-treated patients represent a categorically higher-risk surgical population, at least for this procedure type. However, the authors themselves flag critical limitations: the 98-per-group design is likely underpowered to detect rare but serious events like aspiration pneumonitis, and the retrospective, non-randomized structure introduces selection bias. Notably, all patients underwent standardized preoperative assessment, which may have excluded the highest-risk GLP-1 users, artificially homogenizing outcomes. The study cannot support equivalence claims. Still, for a field where clinical data remain sparse, this 196-patient dataset is genuinely useful — confirmatory rather than paradigm-shifting, and a meaningful step toward evidence-based perioperative protocols for the rapidly growing population of GLP-1 users seeking elective surgery.