Studies show that surgical patients are utilizing herbal remedies more than ever, along with an ever-growing use in the general population. These patients may require special considerations preoperatively.  

aaaaaaaaaaaaaaaaaaaaaaaaaa

Let's consider some of the problems that continue to be roadblocks to providing safe recommendations about herbal use for surgical patients:

Research to identify potential perioperative risks is unfortunately lacking for most herbs.

The belief that, “If it is natural it must be safe.”

Patients may be reluctant to share their use of herbs or supplements with their physician due to a reasonable fear of rejection or disapproval.

Physicians involved in the perioperative care of patients oftentimes do not address alternative medicine uses.

Both parties may be content with a “don’t ask, don’t tell” relationship, which can hinder good medical care.

Both groups may be unaware that potential risks exist with the use of alternative medicine preoperatively.

aaaaaaaaaaaaaaaaaaaaaaaaaa

What can physicians and patients do to overcome these problems and eliminate any undue risks to the surgical patient?

More research is needed to pinpoint what herbal medications may pose a risk to patients.

Knowledge on behalf of the patient and physician of known potential risks of herbal medications.  Hence, "Natural does not always = Safe."

Knowledge on behalf of the physician about potential risks of commonly used herbs and supplements.

Patients must reveal their use of herbs and supplements to their physician to maximize their own safety.

Physicians should ask their patients SPECIFICALLY about their use of herbs and supplements as part of their medication profile in a non-judgmental way. It may be necessary to explain to patients that the reason for asking is to prevent unnecessary complications.

When a patient’s safety or condition is questionable, the physician should order the appropriate tests to rule out the possible risks such as, coagulation and clotting times, liver function tests, electrolytes, EKG, serum drug levels, etc.

Patients should be encouraged to discontinue their herbal medicines and supplements two weeks before surgery to ensure that full metabolism has occurred to prevent unnecessary complications.

aaaaaaaaaaaaaaaaaaaaaaaaaa