Herbal Medicine and Surgery

Herbal remedies (phytomedicines) possess significant pharmacological activity and consequently potential adverse effects and drug interactions. The explosion in sales of herbal therapies has brought products to the marketplace that do not conform to the standards of safety and efficacy that physicians and patients expect. Relatively few physicians inquire about herbal medicine use, and up to 70% of patients do not reveal their use of herbal medicines to their physicians and pharmacists. All physicians should question patients regarding the use of herbal remedies and document their responses in the medical record. They should caution patients that lack of standardization, quality control, and regulation may result in variability in herbal content, efficacy, and potential contamination. Physicians should be aware of potential adverse reactions stemming from herbal medicine use, especially with regard to perioperative bleeding, cardiovascular instability, and interactions with commonly prescribed sedative-hypnotic agents.