Herbal supplements are medications. As I have said in my other posts, just because it is “natural” and you don’t need a prescription, does not mean it isn’t a strong medication. I am still stunned when medications get labeled as “supplements” instead of medications, so they bypass the FDA. The FDA requires pesky things like proving they are safe and effective at what they claim. Instead, herbals fall under the Dietary Supplement Health and Education Act of 1994, so they are regulated with the food.
Anesthesia is an important part of having a surgery. For some of my patients, it is likely the only uninterrupted sleep they have had for a while. I respect the anesthesia risk. My patients have elective (ie they choose to do it), scheduled surgery. For many it is cosmetic. Most of my patients are moms. The safety bar for me is high. It should be high. I only operate in accredited centers, and for general anesthesia I always use a board certified anesthesia doctor.
The anesthesiologists use a combination of IV medication and gases to put you to sleep. They change the dosages based on your weight, length of surgery, etc. Herbal medications can affect the medications they use, by changing the heart and blood pressure dynamics, the liver metabolism of the drug, and other effects. BAD.
EPHEDRA (MA HUANG)
This is an ancient Chinese medication. It is a known stimulant, which constricts blood vessels, increases heart rate, increases blood pressure, and is “thermogenic” (increases metabolism). This was a common weight loss drug. It has also been used for asthma, hay fever, and to increase general “energy.” There are many known severe reactions to this drug. The New England Journal of Medicine in 2000 had a study showing sudden heart attack and severe disability in young people who were taking the drug within the recommended dose. (!!!!) Side effects are many: nausea, dizziness, seizures, heart attack, stroke, and heatstroke (see Steve Belcher and Korey Stringer, both pro athletes who died from heatstroke, likely after using ephedra for its “performance enhancement.”)
SO. This herbal medication is NOT benign. Surgery is a stress. I liken it to running a marathon. In healthy people who are not having surgery, ephedra causes issues. This herbal is well documented to cause heart attack, stroke, heartbeat irregularities, blood pressure issues, and body temperature issues. Supposedly the effects wear off quickly, but this is an herbal proven to be deadly when taken as prescribed. Not worth it.
KAVA
This is a drug from the root of a pepper plant, known to reduce anxiety and cause sedation. Issue? During surgery anesthesiologists use drugs to help patients relax, like Valium, Xanax, and others. Kava augments the action of these other drugs, and it sticks in your system for a while. You may think sedation during surgery is good, why not have more? The issue with oversedation is primarily breathing. If you are too sedated, you don’t breathe.
VALERIAN
Many herbal sleep aids contain valerian. It is also used as an anti-convulsant, migraine, and pain reliever treatment. It acts just like Valium. If you have used it for a while, you can withdrawal if you stop it. It also interferes with sedatives used during anesthesia.
I can’t repeat it enough- herbals, diet pills, and supplements are medication. You need to treat them as such. Please tell your doctor about them before your surgery. And for most, I strongly recommend stopping them 2 weeks ahead of surgery.