Anesthetic risks associated with the use of implantable Glucagon-like Peptide 1 (GLP-1): case report
Marcelo de Jesus Martins, Stefania Lacerda Garcia, Rafael Pereira Espínola, Caroline Paiva Matos Oliveira Martins
Abstract
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used to manage type 2 diabetes and obesity but are associated with gastrointestinal side effects, including delayed gastric emptying. We report the case of a 38-year-old man with hypothyroidism who developed nausea, severe vomiting, and clinical and laboratory signs of dehydration after self-administering a subcutaneous semaglutide implant that lacked authorization from Brazilian national health agencies. A thorough clinical and diagnostic workup was conducted to rule out other causes such as infection or gastric pathology. Upper endoscopy was performed, and ultrasound imaging revealed a 0.3 cm hyperechoic tubular structure in the left gluteal region, corresponding to the reported implant. The device was removed under ultrasound guidance, and the patient’s symptoms resolved completely within hours. This case underscores the risks of using unregulated GLP-1 RA implants and highlights the anesthetic challenges posed by delayed gastric emptying in situations where medication discontinuation is not feasible. It also reinforces the need for regulatory oversight and clear perioperative management guidelines.
Keywords
References
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Submitted date:
12/17/2025
Accepted date:
04/04/2026
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