Herbal medicine or botanicals are increasingly popular. And while medical doctors do not necessarily object to their patients ingesting these non-prescription products, patients undergoing surgery are advised that:
“There have not been enough studies of botanicals in the U.S. for us to state that there definitely will or will not be a reaction during surgery, but most anesthesiologists and surgeons will err on the side of caution…we recommend discontinuing some herbal medications at least two to three weeks prior to surgery.”*
What particularly concerns me and other surgeons is that patients taking these substances often do not regard them as medicines, so when asked, “What medications are you taking,” the patients frequently do not reveal that they are taking these products. According to the American Society of Anesthesiologists, “Seven out of 10 people using these will not tell their physicians.” Our practice’s unswerving routine is to raise the subject with all patients, at the “preoperative visit,” several weeks prior to the surgery date and give them the following list of the more common herbal medications and their potential complications that could arise during surgery.**
Ginseng is used to enhance energy levels. If combined with stimulants used by anesthesiologists, it can cause tachycardia and high blood pressure. It can also decrease the effect of Warfarin, causing the blood to thicken and develop clots.
Ephedra is included in over-the-counter diet aids. It interacts with inhalants used for anesthesia to affect blood pressure. If used with monoamine oxidase inhibitors or Oxytocin, the patient can experience high blood pressure and irregular heart rate during surgery.
Feverfew is often used to treat migraines. It inhibits platelet activity that can increase bleeding during surgery.
Valerian is a mild sedative to help sleep. It causes a potential increase in the effect of barbiturates used in anesthesia, which causes a deeper effect of anesthesia.
Ginkgo Biloba is a circulatory stimulant. It decreases platelet activity and clotting ability.
St. John’s Wort
St. John’s Wort is used to treat anxiety and depression. It may prolong the effects of some narcotics and anesthetics.
Licorice treats symptoms of gastritis and duodenal ulcers. It can cause edema and chronic liver problems and increase the risk of renal insufficiency.
Echinacea is used to enhance the immune system; it may cause hepatotoxicity and possible liver damage.
Ginger treats nausea. It can increase bleeding time.
Goldenseal is a diuretic and laxative. It can worsen edema and increase blood pressure.
*.Jessie A. Leak, M.D., Associate Professor, Department of Anesthesia, M.D. Anderson Cancer Center, Houston, a researcher who specializes in the study of herbal medication.
**Compliments, Jessie A. Leak, M.D.
Herbs, Foods, Spices, and Medications to Be Avoided for at least Two Weeks before Surgery
|Acodeen-30||Borage Seed Oil||Feverfew||Plantain|
|Braska||Fiogesic Tablets and Capsules||Poplar|
|Advil||Bromelain||Fiorinal Capsules and Tablets||Quassia|
|Agrimony||Buff-A-Comp||Fish Oils||Red Clover|
|Alka-Seltzer Extra||Bufferin-All Varieties||Garlic||Robaxisal|
|Alpha Phed Capsule||Carisoprodol||Glepirin Tablets||Safflower|
|Caplets and Tablets||Clove||Heet||Sine-Off|
|Chloracol Capsules||Horseradish||SK–65 Compound Capsules|
|Anacin Maximum||Clinoril||Ibuprofen(Mortrin, Nuprin, Advil, Anaprox)||Solan’s|
|Strength Analbalm||Congespirin||Icy Hot||Soltice|
|Analgesic Balm||Compound||Indocin||Soma Compound (or with Codeine)|
|Anise||Coricidin||Licorice||Southern prickly ash|
|Effervescent||Counterpain Rub||Lini-Balm||Stinging nettle|
|Anti acids and||Damason||Lortab ASA||Supac Surin|
|Pain Reliever||Danshen||Meadowseet||Sweet Clover|
|Anti phiogistine||Darvon with AsjA||Mentholatum||Sweet Vernal|
|4-Way Cold Tablets||Darvon-N with ASA||Meprobamate and Aspirin Tablets||Synalogos DE Capsules|
|Diet Pills||Monaceet with Codeine||Tolectin|
|Arthralgen||Di-Gesic Improved||Morgesic||Tonka bean|
|Arthritis Pain Formula||Dolprin 33||Naprosyn||Turmeric|
|Asafoetida||Dong quai||Northern prickley ash||Vanquish|
|Ascriptin with||Dristan||Neurabaim||Vitamin E|
|Codeine Tablets||Easprin||Oil-O-Sol||Yager’s Liniment|
|Axotal||Empirin with Codeine||Orphengesic||Zomax|
|Bac Tablets||Emul-O-Balm||Pabirin Buffered Tablets|
|Bayer Aspirin Varieties||Esotrin
Pau d’ Arco
|BC Powders||Excedrin Extra||Pepto-Bismol|
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