Original contributionHerbal medicines: current trends in anesthesiology practice—a hospital survey
Introduction
There has been a significant increase in the proliferation and use of dietary supplements including nutraceuticals over the past two decades. Nutraceuticals include all herbal medications, medicinal foods, and vitamins. Although herbal products are neither prescribed nor often recommended by traditional health care providers, patients seeking conventional and unconventional health care are more commonly using these over-the-counter substances. There are more than 29,000 herbal and related substances presently used or available for consumption in the United States.1 The majority of patients do not reveal their use of herbs to their health care providers. In part, patients often consider the herbs to be mere supplements and not constituting drugs or other forms of medicine. When presenting for surgical procedures, such patients may pose a considerable challenge or risk for anesthesiologists in unexpected anesthetic responses during surgery.2, 3 To date, there are no data on the incidence and prevalence of herbal and dietary supplemental use among surgical patients. To address this problem, we administered a survey to 1,017 patients presenting for preanesthetic evaluation in the outpatient clinic of the Department of Anesthesiology at the Texas Tech University Health Sciences Center in Lubbock, Texas.
The purpose of this study was to create awareness among clinical anesthesiologists regarding the use of herbal medicines by patients presenting for a preanesthetic evaluation. As some of these herbs are known to cause unexplained and potentially serious intraoperative hemodynamic alterations, increased bleeding tendencies, and other herb-anesthetic interactions, it becomes prudent for the anesthesiologist to possess a reasonable knowledge and an understanding of these important agents.
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Materials and methods
The herbal survey was developed on the basis of a market study involving leading pharmacies and health stores. An inquiry into the names of the most commonly sold herbal products was performed and the most commonly used herbal products/constituents were then incorporated into the study survey.
After approval by the Institutional Review Board at Texas Tech University Medical Center, Lubbock, Texas, the nutraceutical survey was administered. Patients were first evaluated preoperatively by members
Results
Approximately one in three (32%) of patients admitted to self-administering one or more herb-related compound. Further, the results of the present study reveal that nearly 70% of patients who were taking one or more herbal related agent did not report this information when asked about it during routine anesthetic assessment. Demographic data of the survey population include 58% males and 42% female patients, age range from 18 to 80 years, 53% Caucasians, 33% Hispanics, and 14% blacks and other
Discussion
According to one estimate, 20% of the adult population in the United States use herbal medicines along with prescription drugs.4 In recent years, expenditures on herbal therapies alone have risen to an excess of $5 billion per year.5 Approximately 42% of adult Americans have used at least one alternative therapy (including yoga, relaxation techniques, etc.) in recent years.4 Patients with chronic ailments (e.g., diabetes, arthritis, AIDS, cancer), resort to alternative modalities to
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