SAN FRANCISCO, Calif., Oct 28, 2001 (United Press International via COMTEX) -- Patients should be forthcoming before surgery about all medications and herbal supplements they are taking, a leading expert in herbal treatments and anesthesia told a national gathering of science reporters today.

"Anesthesiologists are increasingly concerned about the fact that many of the patients who come for surgery are on herbal medications," Dr. Jonathan Moss, professor of anesthesia and critical care at the Pritzker School of Medicine at the University of Chicago told United Press International.

"Herbal medications can be very biologically important and should really be treated as drugs. Because we are administering a number of pharmaceutical agents at once -- before, during and after a surgical procedure -- and because blood loss and maintaining proper blood circulation and coagulation are so important, it becomes essential that patients alert the physician to any herbal remedies they may be taking," said Moss. "This disclosure is important at any time, but it becomes crucial before a surgical procedure."

Dr. Moss spoke Sunday at the American Medical Association's 20th Annual Science Reporters Conference in San Francisco.

"It's very hard to get a handle on this. There are no placebo-controlled double blind trials on the effect of herbals on surgical outcomes and side effects. What we do know is that the active product or 'name' ingredient that you get in products in the grocery store or the pharmacy has a 200 percent variability rate--which means that you don't really know how much you are getting. It is very easy in this kind of market situation to have herbal intakes that will interfere with bleeding control and our anesthetic medications," Moss said.

"If you get a paper cut and you're taking gingko, it's not a big deal, but if you're taking gingko and you have a hip replacement, it may be a big deal. We can give blood transfusions, but if we can minimize giving blood by reducing bleeding, that's even better," he added.

Moss identifies eight of the most commonly used herbs that, from case studies, appear to effect surgical outcomes: valerian, echinacea, ephedra, ginkgo biloba, kava, garlic, ginseng and St. John's wort. He suggests that a patient first disclose his or her use of herbal supplements to his or her physician and surgical team.

Moss has relied largely on a series of published case reports to document his concerns. "To complicate matters, there is no real reporting mechanism for adverse reactions to herbs. This makes it difficult to study the effects of herbs because it is almost impossible to retrospectively define what the patient has taken and how much of the biologically active component of the herb was really taken," he explains. "Studying herbal adverse reactions is not like studying beta-blockers taken in exact amounts. Right now we don't have access to purified compounds as we do with conventional drugs."

The American Society of Anesthesiologists (ASA) recommends that patients should stop taking herbal products at least 2 to 3 weeks prior to surgery. If surgery is necessary more quickly, patients should bring the product to the hospital in the original container so the anesthesiologist can determine the exact ingredients.

Former ASA president said, Dr. John Neeld, Jr. adds to this recommendation, "Just because these medicines are labeled 'natural' or 'herbal' does not mean that they are safe or harmless."

　　From Healthy.net