REVIEW Herbal Medicines and Perioperative Care

THERE IS ENORMOUS PUBLIC EN-thusiasm for herbal medica-tions. Two recent surveys havefound widespread use among the presurgical population.1,2 Morbid-ity and mortality associated with herbal medications may be more likely in the perioperative period because of the polypharmacy and physiological alter-ations that occur.3 Such complica-tions include myocardial infarction, stroke, bleeding, inadequate oral anti-coagulation, prolonged or inadequate anesthesia, organ transplant rejection, and interference with medications in-dispensable for patient care. Of the herbal medications that cli-nicians are likely to encounter, we hav