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Possible interaction between sevoflurane and Aloe vera.

Anna Lee¹, Po Tong Chui, Cindy S T Aun

¹Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong, China.

The Annals of Pharmacotherapy

|August 5, 2004

Summary

Aloe vera tablets and sevoflurane anesthesia may interact, increasing bleeding risk during surgery. Discontinue herbal supplements with antiplatelet effects before procedures to ensure patient safety.

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Area of Science:

Anesthesiology
Pharmacology
Herbal Medicine

Background:

Aloe vera is widely used for its anti-inflammatory, antibacterial, and lipid-lowering properties.
Potential antiplatelet effects of Aloe vera are attributed to its compounds that may reduce prostaglandin synthesis and inhibit platelet aggregation.

Observation:

A 35-year-old woman experienced 5 L of intraoperative blood loss during surgery.
This massive bleeding occurred following oral consumption of Aloe vera tablets.

Findings:

The patient's bleeding was potentially exacerbated by an interaction between Aloe vera and sevoflurane, an anesthetic agent.
Both Aloe vera and sevoflurane possess antiplatelet effects, which can impair blood coagulation and prolong bleeding.
While patient-specific factors like hemangioma vascularity were significant, the herb-drug interaction played a contributory role in the adverse event.

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Implications:

This case highlights a potential herb-drug interaction between Aloe vera and sevoflurane, emphasizing the importance of a thorough medication history.
Herbal medications with known or suspected antiplatelet activity should be discontinued prior to anesthesia and surgical procedures.
Clinicians should exercise caution regarding the concomitant use of herbal supplements and anesthetic agents due to potential synergistic effects on hemostasis.