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Dr. Geeta Ahlawat, Dr. Mangal Singh Ahlawat*


Products made from plants that are used to maintain or improve health have a long history of use and claimed health benefits. Most patients fail to report their usage during history taking. However, many herbal supplements have potent pharmacologic activity by themselves and, along with various additives incorporated in various preparations can contribute to adverse effects and drug interactions. The use of herbal supplements by patients in the perioperative period is common and consistent with the substantial increase in the use of alternative medical therapies. We reviewed the literature to examine the constituents, safety, pharmacokinetics, and pharmacodynamics of those herbal supplements that are commonly used. Different supplements possess antiplatelet activity, adversely interact with other drugs, have gastrointestinal manifestations, produce organ toxicities, and produce additive effects when used with sedatives. With the increasing use of herbal supplements by patients, there is now a definite need to screen patients preoperatively for use of these supplements to prevent potential adverse events that may arise from herbal medications taken alone or combined with conventional therapies during the perioperative period. The American Society of Anesthesiologists (ASA) suggests that all herbal medications should be discontinued 2 to 3 weeks before an elective surgical procedure.

Keywords: health, supplements, ASA.

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