Dangers of Herbs and Surgery

According to an article in the June issue of the Journal of the American Chiropractic

Physicians from the University of Chicago warn that surgical patients taking herbal medicine should consider the possible effects of herbal remedies combined with anaesthetics.

The July 11 issue of JAMA reports that powerful herbal remedies can affect heart rate, blood clotting, the immune system and the effects of anaesthesia.

Patients should advise their surgeons if they are being treated with herbal medicine before their operation and consider stopping the use of herbal medicine before surgery.

The researchers made the following specific recommendations:

***ECHINACEA... Boosts immunity ... Allergic reactions, impairs immune suppressive drugs, can cause immune suppression when taken long-term, could impair wound healing... Discontinue as far in advance as possible, especially for transplant patients or those with liver dysfunction.

***EPHEDRA (ma huang)... Increases heart rate, increases blood pressure... Risk of heart attack, arrhythmias, stroke, interaction with other drugs, kidney stones... Discontinue at least 24 hours before surgery.

***GARLIC (ajo)... Prevents clotting... Risk of bleeding, especially when combined with other drugs that inhibit clotting. ...Discontinue at least 7 days before surgery.

***GINKO (duck foot, maidenhair, silver apricot) Prevents clotting... Risk of bleeding, especially when combined with other drugs that inhibit clotting... Discontinue at least 36 hours before surgery.

***GINSENG... Lowers blood glucose, inhibits clotting, lowers blood-sugar levels... Increases risk of bleeding. Interferes with warfarin (an anti-clotting drug)... Discontinue at least 7 days before surgery.

***KAVA (kawa, awa, intoxicating pepper)... Sedates, decreases anxiety... May increase sedative effects of anaesthesia. Risks of addiction, tolerance and withdrawal unknown... Discontinue at least 24 hours before surgery.

***ST. JOHN'S WORT (amber, goatweed, Hypericum, klamatheweed... Inhibits re-uptake of neuro-transmitters (similar to Prozac... Alters metabolisms of other drugs such as cyclosporin (for transplant patients), warfarin, steroids, protease inhibitors (vs HIV). May interfere with many other drugs... Discontinue at least 5 days before surgery.

***VALERIAN... Sedates... Could increase effects of sedatives. Long-term use could increase the amount of anaesthesia needed. Withdrawal symptoms resemble Valium addiction... If possible, taper dose weeks before surgery. If not, continue use until surgery. Treat withdrawal symptoms with benzodiazepines.

Friday, 10 August 2001