Anesthetic Safety and Perioperative Outcomes in GLP-1 Receptor Agonist-Treated Patients Undergoing Lipoabdominoplasty.

INTRODUCTION: The increasing use of glucagon-like peptide-1 receptor agonists (GLP-1 receptor agonists) for pharmacological weight loss has led to a growing number of patients undergoing body-contouring procedures after rapid weight reduction. Given their effects on gastric emptying, metabolism, and nutritional status, concerns have been raised regarding potential implications for anesthetic management and perioperative safety. However, clinical data addressing anesthetic outcomes in this population remain limited. METHODS: This retrospective comparative observational study included patients undergoing highdefinition lipoabdominoplasty under general anesthesia. Group A consisted of patients receiving GLP-1 receptor agonists (semaglutide or tirzepatide), while Group B included patients not receiving such therapy. All patients underwent standardized preoperative assessment and surgical management. Primary outcomes were intraoperative adverse events, including respiratory complications, hemodynamic instability, and arrhythmias. Secondary outcomes included perioperative parameters (anesthesia and surgical duration, intraoperative EtCO₂ and SpO₂), recovery metrics (time to awakening, mobilization, and discharge), and early postoperative complications. Statistical comparisons were performed using appropriate parametric and non-parametric tests. RESULTS: A total of 196 patients were included (98 per group). No statistically significant Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation differences were observed between groups in demographic or baseline characteristics. Intraoperative parameters remained stable in both groups, with no clinically relevant respiratory events reported. Recovery profiles showed similar trends, with comparable times to awakening, mobilization, and discharge. The incidence of postoperative nausea and vomiting, pain scores, and early complications (seroma, infection, delayed wound healing, and hyperpigmentation) did not differ significantly between groups. DISCUSSION: Within the limitations of this study, no statistically significant differences were observed between patients receiving GLP-1 receptor agonists and controls in terms of intraoperative stability, recovery profile, and early postoperative outcomes. CONCLUSION: These findings should not be interpreted as evidence of equivalence, as the study was not designed for non-inferiority or equivalence testing and may be underpowered for rare events. Further prospective studies with larger sample sizes and stratification by specific GLP-1 receptor agonists are warranted. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .