As with prescription medications, certain herbs and supplements can have inadvertent effects or consequences that may be relevant when undergoing anesthesia and surgery. Increased bleeding risk, blood pressure variations and unpredictable response to anesthesia have all been ascribed to certain supplements. It is important to notify your physician about not only your prescription medications, but also your vitamins, herbs and other supplements. Unfortunately, a fair number of surgeons and anesthesiologists may be unfamiliar with both the supplements and their potential interactions or effects on medical and surgical treatment. It is prudent for us to take charge of this information and make sure we as patients are aware and discuss it with our healthcare providers. This often needs to take place a week or two before surgery so that certain herbs or supplements can be stopped ahead of time so their effects can wear off.
Many supplements have been characterized as having potential undesirable interactions during surgery and anesthesia; however, the effect itself is why we may use the supplement in the first place. For example, an herb that helps prevent blood clots can be beneficial, just not during an operation when we want to encourage clotting in the surgical field and decrease blood loss.
In general, supplements can affect three areas of anesthesia and surgery:
- Decreased blood clotting, hence, increased bleeding risk: Vitamin E, Ginko Biloba, Omega 3 (Fish Oil greater than 3gm/day), Garlic, Ginseng, Bilberry, Feverfew, Ginger and Red Clover
- Depression or elevation of blood pressure: Black Cohosh, Fenugreek, Garlic, Hawthorn, Ginseng, Ephedra and St. Johns Wort.
- Effects on anesthesia: St. John’s Wort, Kava, Ephedra (Ma Huang), Melatonin and Valerian
This is a list of some of the more common supplements and herbs that may have effects. Discuss what you’re taking with your healthcare providers ahead of time and decide if you need to stop taking them prior to anesthesia and surgery.