Preoperative Evaluation: Herbals Away
Provided by: Chris Campton, RN, MS, GNP-C
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Performing a thorough evaluation of patients before a surgical
procedure is an important step in process to decrease the chance of a
perioperative complication. Certain medications can have an impact on
volume status, electrolyte balance, or coagulation. They may also interact
with anesthesia. Most patients readily list medications they are taking
or produce a card from their wallet with a list. Often however, unless
prompted, they will not list those over-the-counter or herbal preparations that are not
really considered "medicine".
Many herbals, if taken in large enough
quantities, can have a very significant and unfavorable effect in the
surgical setting. Although the mechanism of action is often not known,
enough evidence exists to warn against using certain herbals prior to
surgery.
The following is a partial list of herbals that patients should stop
taking 7-10 days prior to surgery:
Herb Action:
Garlic Inhibits platelet aggregation
Dandelion Diuretic
Dong Quai Decreases blood pressure
Ephedra Increases blood pressure and pulse
Kava Decreases platelets, WBC's and albumin
Licorice Decreases potassium
Pau D'Arco Anticoagulation effect
St. John's Wort Possibly an MAO inhibitory effect. Stop 2-3 weeks prior to surgery.
Ginkgo Biloba Blocks platelet activating factor
Ginger Inhibits platelet aggregation
Feverfew Inhibits platelet aggregation
WARNING: THIS IS NOT AN ALL-INCLUSIVE LIST.
Last updated: June 10, 2000
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