Garlic-Induced Surgical Bleeding: How Much Is Too Much?

Area of Science:

• Neurosurgery
• Pharmacology
• Hematology

Background:

• Spinal fusion surgeries, like C2-T2 decompression and fusion, carry risks including significant intraoperative bleeding.
• Patients are typically screened for medications affecting coagulation, but dietary supplements are often overlooked.
• Understanding potential interactions between dietary supplements and surgical outcomes is crucial for patient safety.

Observation:

• A patient experienced excessive intraoperative bleeding during a C2-T2 decompression and fusion procedure.
• The bleeding source was unclear, and the patient denied using anticoagulant or antiplatelet medications.
• The patient reported consuming approximately 12g of garlic daily in the days preceding the surgery.

Findings:

• Garlic is known to possess antiplatelet properties, potentially increasing bleeding risk.
• The significant daily intake of garlic may have contributed to the patient's intraoperative hemorrhage.
• Treatment with desmopressin acetate (DDAVP) and cryoprecipitate effectively managed the bleeding.

Implications:

• This case underscores the importance of inquiring about dietary supplement use, particularly herbs like garlic, before surgical procedures.
• Further research is needed to establish the dose-dependent effects of garlic on hemostasis and its potential interactions with other medications.
• Clinicians should consider the antiplatelet effects of garlic when assessing bleeding risk in surgical patients.