Going For Surgery? Remember This..

My doctor colleagues were quite puzzled recently when a patient, after undergoing routine surgery, took a longer time than usual to wake up after GA was completed and stopped. The patient required an overnight stay in the ICU before finally waking up 24 hours later! It was subsequently discovered that the patient had been taking supplements, in this case, St John’s Wort.

evening-primrose-oil

This popular supplement,EPO, needs to be stopped 2 weeks prior to surgery (see text)

Before undergoing surgery, one important info which must be disclosed to your doctor is whether you are taking herbal supplements. This is often left out by patients when doctors enquire on what medications they are taking, as often many people do not equate medicines with supplements.

Many intensive care physicians including anaesthesiologists will tell you of their experience with patients who take a long time to wake up after surgery; develop fits upon recovery or bleed excessively after surgery; all due to the taking of herbals.

Incidents like the above used to mystify many doctors previously but evidence is now clear that several over-the- counter supplements can interfere with the various actions of medications used during surgery.

Take a look below at some common examples:

Herbal supplement Possible complications
Aloe vera May cause increased intestinal muscle movement to digest food (peristalsis), may decrease effectiveness of water pills (diuretics) given after surgery
Bromelain May cause bleeding or interact with antibiotics such as amoxicillin or tetracyclines
Danshen May cause bleeding
Dong quai May cause bleeding
Echinacea May interfere with immune functioning, may alter effectiveness of immunosuppressant drugs given after transplant surgery
Ephedra May cause abnormal heartbeat, may cause extreme high blood pressure and coma if combined with certain antidepressants and anesthesia
Feverfew May cause bleeding
Garlic May cause bleeding, may interfere with normal blood clotting
Ginger May cause bleeding
Ginkgo May cause bleeding
Ginseng May cause bleeding, may cause rapid heartbeat, may cause high blood pressure
Goldenseal May cause or worsen swelling and high blood pressure
Kava May enhance sedative effects of anesthesia
Licorice (not including licorice candy) May increase blood pressure
Omega-3 fatty acids May cause bleeding if taken in doses greater than 3 grams a day
Senna May cause electrolyte imbalance
St. John’s wort May increase or decrease the effects of some drugs used during and after surgery
Valerian May prolong the effects of anesthesia
The above list is not exhaustive. As more cases are encountered, the list gets longer!
Evening Primrose Oil (EPO) is now implicated in the cause of fits or seizures following general anaesthesia.
Some points to note if you are undergoing planned surgery:
  1. Remember that the list of medications that you need to reveal to your doctor includes all supplements, whether as pills or as a drink.
  2. Some of these herbals may have to be stopped more than 2 weeks prior to planned surgery.
  3. In emergency surgery, remember to reveal to your doctor and next-of-kin what you are taking so that some preventive measures may be undertaken beforehand by the doctors.
  4. Some people believe if something is natural, it is safe. That is not necessarily true. If in doubt, show your care-giver the original container of the supplement.


Share this Post

Advertisements

4 responses

  1. Thanks for this insight – I’m now wiser! I enjoy your blog posts. Keep it up!

    Doctor2008: Thanks, Karen. Pass the word round!

  2. I’d not take any supplements-after my surgery, even though i was conscious i felt sleepy and groggy for nearly a day.
    Doctor2008 says: There are many other possibilities, including sleep apnoea (see my posting) and interactions with other medications given by your doctor, like antibiotics!

  3. Your posting is a revelation!
    Thanks!

  4. thanks, very well written post, found it through a random google search and i shared it on my stumble upon account

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: