SURGERY
SURGERY PATIENTS AT RISK FOR HERB-ANAESTHESIA INTERACTIONS
The use of herbal medicines and nutraceuticals among patients
about to have surgery is becoming more widespread, yet most
patients do not tell their physicians. In one study 979
patients who were about to have surgery were asked about
their use of herbal remedies and nutraceuticals (supplements
not derived from plants). One hundred and seventy (17.4%)
patients reported taking such products. The most often used
herbs were ginkgo biloba (32.4%), ginseng (26.5%), and garlic
(26.5%). Patients are recommended to stop taking herbal
preparations at least 2 weeks before elective surgery. Warning
about possible side-effects are given for the following
herbal remedies:
Ephedra: may interact with antidepressants
or antihypertensives to cause increases in blood pressure
or heart rate.
Feverfew: may increase bleeding, especially
in patients already taking anticoagulants.
Ginkgo: side effects as feverfew.
Garlic: side effects as feverfew.
Ginseng: may decrease effectiveness of
some anticoagulants; use associated with hypertension, tachycardia,
bleeding.
Kava-kava: may increase effects of some
anti-seizure medications or prolong effects of some anaesthetics.
St John’s Wort: may prolong effects
of some narcotics and anaesthetics.
Larkin, M
LANCET 2000, 354 (9187) 1362
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