Preanesthetic Assessment of Herbal and Dietary Supplement Use
Uniformed Services University Of The Health Sciences Bethesda United States
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The use of unregulated herbal and dietary supplements in the United States is steadily increasing, and anesthesia providers are becoming increasingly concerned about the potential for adverse drug reactions. Anesthesia providers knowledge regarding the useof supplements and their potential interaction with anesthetics is largely unreported in the literature. This descriptive, two-phased study examined current practice of United States Air Force USAF Certified Registered Nurse Anesthetists CRNA regarding herbal and dietary supplements in the preanesthetic medication assessment and the use of herbal and dietary supplements by patients undergoing anesthesia in a USAF medical center. In phase-I, a convenience sample of 220 USAF CRNAs was surveyed using a seven-item questionnaire. Of 126 USAF CRNA respondents, 58 reported asking their patients about supplement use. Eighty-five percent of all respondents reported that this issue is an important part of the preanesthetic assessment. Fifty-three percent of respondents commonly recommend discontinuing supplement use at least 48 hours prior to surgery, while 47 of respondents do not make recommendations. Twelve percent of respondents reported that they have suspected an anesthesia-supplement reaction, most commonly, coagulation problems or sympathetic nervous system alterations. In phase-II of the study, 86 patients presenting to the preanesthetic clinic at an USAF medical center were asked about herbal and dietary supplement use. Twelve percent reported taking herbal supplements and 24 reported dietary supplement use.