The Peri-Operative Implications of Herbal Medicines

Anaesthesia. 2002 Sep;57(9):889-99. doi: 10.1046/j.1365-2044.2002.02781.x.


An increasing number of patients are taking herbal medicines such as echinacea, garlic, ginkgo biloba, ginseng, St John's Wort, valerian, ephedra, kava, grapefruit juice and ginger. Although these herbal medications are considered 'natural' products that may have some benefits, adverse effects such as increased bleeding tendencies and drug interactions are associated with their use. Surgeons and anaesthetists may be unaware of their patients' use of these medications because it is common for patients not to disclose their use of this form of medication, and both surgeons and anaesthetists often fail to enquire about their use. Anaesthetists and surgeons must be familiar with the effects of herbal medicines and should specifically enquire about the use of herbal medicines during pre-operative assessment. Currently available data suggest that all herbal medicines should be ceased 2 weeks before surgery.

Publication types

  • Review

MeSH terms

  • Anesthesia
  • Blood Loss, Surgical
  • Drug Interactions
  • Echinacea / adverse effects
  • Garlic / adverse effects
  • Ginkgo biloba / adverse effects
  • Humans
  • Intraoperative Complications*
  • Panax / adverse effects
  • Phytotherapy / adverse effects*
  • Plant Extracts / adverse effects*


  • Plant Extracts