Herbal Medications and Anesthesia Case Management

Herbal medicine use in the United States has increased substantially. Despite this upward trend, patients often fail to disclose use of these medicines to their healthcare provider. Currently, the US Food and Drug Administration (FDA) does not require preclinical animal studies, controlled clinical trials, or postmarket surveillance of herbal supplements. Lack of FDA oversight leads to product variation in quality, purity, efficacy, harvesting, and storage. Intentional or unintentional addition of contaminants to these products remains substantial. Because herbal medicines have the potential to adversely react with medications used in the perioperative period, anesthesia providers should be aware of the purported uses of common herbal supplements, potential drug interactions with these medicines or possible contaminants, and the anesthetic implications for patients who use these medicines.