Herbal medicine and anaesthesia

Area of Science:

• Pharmacology
• Anesthesiology
• Integrative Medicine

Background:

• Herbal medicine use is rising globally, with patients often not disclosing usage to healthcare providers.
• This lack of disclosure can lead to undisclosed herb-drug interactions, particularly concerning in surgical settings.
• Chronic disease management is a key driver for increased interest in complementary and alternative therapies.

Purpose of the Study:

• To highlight the potential adverse perioperative herb-drug interactions associated with herbal medicine use.
• To emphasize the importance of anesthesiologists obtaining a comprehensive herbal medicine history from patients.
• To provide guidance on managing risks and preventing complications during anesthesia and surgery.

Main Methods:

• Review of existing literature on herb-drug interactions relevant to anesthesia.
• Analysis of reported cases and potential mechanisms of herb-induced perioperative complications.
• Clinical recommendations based on pharmacological principles and patient safety.

Main Results:

• Herbal medicines can cause significant adverse effects during anesthesia, including coagulation disorders, cardiovascular instability, and altered drug metabolism.
• Specific herbs can prolong the effects of anesthetic agents or cause hepatotoxicity.
• Failure to identify herbal medicine use can lead to unpredictable and severe perioperative outcomes.

Conclusions:

• Anesthesiologists must proactively screen patients for herbal medicine use before surgery.
• Identifying and managing potential herb-drug interactions is critical for patient safety.
• Discontinuation of certain herbal medicines for at least two weeks prior to anesthesia is recommended if interactions are suspected.