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Warnings and Interactions: Herb Use and Surgery

Warnings and Interactions

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Herb Use and Surgery

Many Popular Herbs may pose a risk when mixed with surgery or anesthesia:

"Patients should tell their surgeons about all herbal products they use, along with prescriptions and over-the-counter remedies, to avoid dangerous interactions", according to Dr. Charles McLeskey, an anesthesiologist at Scott & White Memorial Hospital in Temple, Texas.

McLeskey was presenting the results of a survey of 979 presurgical patients at a 1999 Dallas, TX conference of the American Society of Anesthesiologists. According to those results, seventeen percent of patients surveyed said they take one or more herbal products.

Among the most common herbs on the list of products used were several popular herbs which may prevent blood clots from forming and lead to excess blood loss in surgery, including gingko biloba, garlic, ginger and ginseng. This should come as no surprise to the experienced herbalist, as several of these herbs are used to promote increased circulation, or to prevent conditions caused by blood clots, such as heart attack and stroke, specifically because of these effects.

Likewise, certain other popular herbs, commonly used for their antidepressant or relaxant effects "may prolong the sedative effect of anesthesia", McLeskey said. The most common examples of this group include St. John's wort, an antidepressant, and kava-kava, a relaxant.

According to suggestions from the American Society of Anesthesiologists, patients should stop taking herbal products at least two weeks before elective surgery and keep their doctors informed.

[Author Note: as with ANY medical treatment, it is important to consult with your treatment professionals before stopping any long-term treatment, and balance the risks and benefits of stopping against the risks and benefits of continuing treatment. Some herbal treatments, like many pharmaceuticals, should not be stopped suddenly, or without replacing the treatment with an alternative. Herbal treatment of this nature, or of any serious condition, should be managed by an expert in this field, in order to ensure that any interactions or condition-specific concerns can be foreseen and addressed.

Likewise, it is important for all members of your health care team to be kept fully informed of all treatments and other health care decisions made by you, or any member of your team. For this to work well, your primary caregiver must be comfortable practising complementary medicine, and practising as part of a health care team. However, in any surgical situation, it is the surgeon who must be the acknowledged leader of the team, and the surgeon and/or anaesthesiologist's concerns should be taken seriously and addressed to their satisfaction before proceeding.]

The makers of dietary supplements agree: according to a spokeswoman for the Council for Responsible Nutrition, their representative body, "Anytime they are taking a dietary supplement they [patients] should mention that to their doctor." Cathy Fomus said, "They can interact with food, with each other and other prescription drugs." She recommended that patients should try to bring the bottles with them anytime they visit a doctor or hospital.

Source: 1999 Associated Press article
as reported on

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