Safe Use of Herbal Medicines Before Anesthesia

The safety and efficacy of herbal products have not been studied in detail.

For the safe use of these products:

• Be sure to consult your doctor.
• Do not use higher amounts than the recommended dosage.
• Use under the supervision of an educated professional.
• Use with caution if you are pregnant or lactating.
• Do not forget that these supplements you take may contain additives that may interact with anesthesia and may harm you or your baby.

The use of herbal medicines dates back to ancient times in medicine. In fact, some of the prescription medicines on the market today are derived from various herbal products.

The most common are:

The most common ones include Echinacea, Tickseed, Garlic, Ginger, Ginkgo Biloba, Ginseng, Hoodia, Kava Pepper, St. John's Wort, Reishi Mushroom, and Valerian.

Herbal products are available in tablet, liquid, granule, or powder form and are commonly sold in the form of herbal tea. They can also be purchased naturally from herbalists.

• In our society, everything that is natural is believed to be safe. However, this is not always true.
• While many herbal products offer health benefits when used correctly, using herbal products until the day of surgery or diagnostic procedure may affect the success of anesthesia or other interventions. Herbal products can interact with anesthetics.
• Since herbal medicines used in traditional Chinese medicine are made up of different mixtures, it is difficult to determine the exact amounts of each herb they contain.
• The use of herbal medicines may not be an absolute obstacle to surgery and anesthesia. You should inform your anesthesiologist and surgeon about all herbal products and supplements that you use.
• Stop taking herbal products at least 2 weeks before scheduled procedures or surgeries to avoid side effects.
• If you are using an herbal product, inform your surgeon and anesthesiologist.
• When asked about your medication history, provide information about all addictive drugs, herbal products, dietary supplements, minerals, and teas that you are taking.
• If you are not sure about the content of the herbal product, bring the product and its contents with you before the surgery.
• Find out about the herbal products that your spouse and family members use. In an emergency, this information should be shared with healthcare professionals.
• Herbal products should be considered as medications. Even if the product is natural, it can still be harmful. Possible side effects increase with the number of products you take.

Sage: It may raise blood pressure. Its use is not recommended for pregnant and lactating women due to the threat of miscarriage.
Tickseed: It can lead to migraine, insomnia, anxiety, joint stiffness, and prolongation of bleeding time.
Echinacea: When used for a long time, it suppresses the immune system.
Ginkgo Biloba: It may increase bleeding.
Ginseng: It may cause insomnia, irritability, and cardiac side effects.
Hoodia: It may cause blood sugar changes and rhythm disturbances.
Black Cohosh: It lowers blood pressure and can increase bleeding.
Kava Pepper: It is sedative, may cause liver damage, and may interact with medications.
Valerian: It may lead to an increased sedative effect.
Reishi Mushroom: It may prolong bleeding time.
St. John's Wort: It is sedative, and may cause interactions with other medications and blood pressure changes, prolonging the anesthetic effect.
Garlic: It may cause blood pressure changes and an increase in bleeding time (especially if taken with Aspirin and Gingko.) 
Senna: It may cause electrolyte imbalance. It should not be used for a long time.
Ginger: It may cause a sedative effect and risk of bleeding.