HOW HERBAL PRODUCTS INCREASE SURGICAL RISK
NUMBEROUS HERBAL SUPPPLEMENTS increase risks associated with surgery and
anesthesia. To keep patients safe, the American Society of Anesthesiologists recommends
patients discontinue their herbal medicines at least 2 or 3 weeks before surgery. Use the
following list of potential complications associated with common herbal products to protect your
patients.
SUMMARY REVIEW OF HERBS AND ANESTHESIA-RELATED CONSIDERATIONS.
Herb
Anesthesia considerations
Echinacea
Possible negative impact on the liver
Subsequent interference with hepatic metabolism of certain anesthesia medications
Ephedra sinica
Increased risk of cardiac dysrhyhmias
May reduce effectiveness of medications used to treat hypotension
Feverfew
Potential for increased bleeding
Garlic
Potential for increased bleeding
Ginkgo biloba
Potential for increased bleeding
Ginseng
May increase anesthetic agent requirements
Potential for hypoglycemia in patients taking insulin or oral diabetes agents
May reduce the efficacy of warfarin
Kava
May potentiate muscle relaxants
May increase effects of certain antiemetics
Potential for hypokalemia and associated cardiac dysrhythmias
Licorice
May cause hypertension
St. John’s wort
May increase risk of stroke and cardiac complications through potentiation of
sympathetic nervous system stimulants
May increase effects of barbiturates and opioids
Valerian
May increase effects of anesthetic agents
Yohimbe
May increase anesthetic agent requirements
May cause paresthesia and dissociative states