Information You Will Want to Share
Medical herbs have been used since the beginning of time. In fact, many of the prescription drugs on the market today are derived from plant products. Herbal products are also known as dietary supplements, alternative therapies, complementary medicine, and homeopathic or holistic healthcare.
Some of the most common herbal products are: Echinacea, Feverfew, Garlic, Ginger, Ginkgo Biloba, Ginseng, Hoodia, Kava, St. John's Wort, and Valerian.
Herbal products are available as tablets, liquids, granules, or powders, and are commonly contained in herbal teas. They may be available in their natural state as well.
The Dietary Supplement Health & Education Act of 1994 recognizes "herbal products" as foods or dietary supplements. Therefore, they are not regulated by the Food and Drug Administration (FDA). There are few instructions on proper use, dosage requirements, possible side effects, toxicity and possible drug interactions. This makes it difficult to predict the patient's reaction or to know whether the herbal products are working.
People believe if something is natural, it is safe. That is not necessarily true.
While many herbal products offer noticeable health benefits when used correctly, taking herbal products right up until the day of your surgery or diagnostic procedure may have an impact on the success of your anesthetic and procedure. Herbal products may interact with anesthetics.
Some of the potential side effects are increased surgical bleeding, heart and blood pressure effects, reaction with sedatives and changes in the body's reactions to certain medications.
 Unlike Western medicine, traditional Chinese herbal remedies often consist of mixtures of herbs making it difficult to determine the exact amounts of each herb you are taking.
Use of herbal medications is not an absolute contraindication for surgery and anesthesia. It is absolutely essential that you tell your anesthesia provider and your surgeon about all the herbal products and other supplements you may be taking.
- STOP taking the herbal product at least two weeks prior to the scheduled procedure or surgery to prevent side effects.
- Inform your surgeon and anesthesia provider that you are taking an herbal product.
- When asked about your medication history, include all over-the-counter drugs, herbal products, dietary supplements, minerals, and teas.
- If you are not sure of the contents of an herbal product, then bring the product and the container it comes in with you for the preoperative anesthesia interview.
- Make sure that your spouse, a friend, and/or a family member is aware that you take an herbal product. In the event that you need emergency care, he/she will need to share this information with your healthcare providers.
- Realize that herbal products need to be treated as medicine. Even if the product is natural, it still may be harmful.
- Possibilities for interactions are endless and the risks increase with the number of products you are taking.
Black Cohosh
Blood pressure decrease; may increase bleeding.
Echinacea
Immune suppression; liver inflammation.
Feverfew
Migraine, insomnia, anxiety and joint stiffness; risk of prolonged bleeding.
Garlic
Blood pressure changes; risk of prolonged bleeding.
Ginger
Sedative effects; risk of bleeding, especially if taken with aspirin and ginkgo.
Ginkgo Biloba
May increase bleeding.
Ginseng
Insomnia and irritability; risk of cardiac effects
Hoodia
Changes in blood sugar; possible arrhythmia.
Kava
Sedative effects; potential liver toxicity; risk of additive effect to medications.
St. John's Wort
Sedation; blood pressure changes; risk of interaction with other medications that prolong effects of anesthesia.
Valerian
Increased Sedative effects.
The dietary and herbal supplement industry is unregulated. Safety and effectiveness are largely unstudied. To use an herbal product as safely as possible:
- Consult your doctor first.
- Do not take a bigger dose than the label recommends.
- Take it under the guidance of a trained professional.
- Be especially cautious if you ar epregnant or nursing.
Recognize that the supplement you take may have various additives that can interact with anesthesia, or may harm you and your baby.
Ang-Lee, K, Moss, J, Yuan, C. 'Herbal Medicine and Preoperative Care.' JAMA. 2001;286(2):208-216.
Dietary Supplement Health & Education Act of 1994, 103rd Congress, Public Law 103-417, pub#103-417. Washington, D.C., U.S. Government Printing Office, 1994.
Heyneman CA. Preoperative considerations: which herbal products should be discontinued before surgery? Crit Care Nurse. 2003;23:116-124.
Lee A, Chui PT, Aun CS, Lau AS, Gin T. Incidence and risk of adverse perioperative events among surgical patients taking traditional Chinese herbal medicines. Anesthesiology. 2006;105:454-461.
Naushad AN. Herbs and Anesthesia. Meo Publications. 2002.
Norred, C, Zamudio, S, Palmer S. Use of Complementary and Alternative Medicines by Surgical Patients. AANA J 2000;68:13-18.
Olson G. When pregnant patients use nutritional and herbal supplements. Contemporary Ob/Gyn. 2001;46:63-81.
Wade C. Hormone-modulating herbs: implications for women's health. Journal of the American Womens Association. 2001;54:181-183.
Web Sites
American Association of Nurse Anesthetists: www.aana.com and www.anesthesiapatientsafety.com
American Botanical Council: www.herbalgram.com
FDA Center for Food Safety and Applied Nutrition: www.cfsan.fda.gov
Herbal Interactions, May Clinic: www.mayoclinic.com
NIH-National Center for Complimentary and Alternative Medicine: http://nccam.NIH.gov
 About the Council for Public Interest in Anesthesia
Established by the American Association of Nurse Anesthetists (AANA) in 1975, the Council for Public Interest in Anesthesia is charged with the responsibility to address issues that affect the public in matters of nurse anesthesia practice, including patient education and advocacy.
The CPIA is a multidisciplinary body of individuals that includes nurse anesthetists and public representatives. The CPIA is responsible for the AANA Wellness Program by promoting CRNA wellness for career longevity and personal satisfaction. The Council also acts as the autonomous appellate body for the credentialing councils of nurse anesthetists and their educational programs.
Bridging Public Safety and Practitioner Wellness
See more information about the
Council for Public Interest in Anesthesia
Brochures and Resources
|