Current management of patients taking herbal medicines

Increasing numbers of patients taking herbal medicine products are presenting for anaesthesia and surgery. Anaesthetists need to consider the perioperative implications of herbal medicines and should, therefore, have some knowledge of this subject.A postal questionnaire survey was sent to a random 5% of practising members of the Association of Anaesthetists of Great Britain and Ireland residing in the UK, to identify attitudes, practice and knowledge regarding herbal medicines.From 341 questionnaires there were 221 replies, a 65% response rate. Ninety per cent stated that they seldom or never asked patients about herbal medicine usage, yet 65% felt that there could be potentially harmful effects of herbal medicines in the perioperative period. There was a very poor level of knowledge with respect to the current management of 10 well-known herbal medicines. However, 75% agreed that information about perioperative usage of herbal medicines is important, and 77% felt that herbal medicines should be in the undergraduate medical curriculum. Reading was the usual source of herbal medicine product information. Most (82%) felt their knowledge of herbal medicine products and the implications in patient care were inadequate.This sample of anaesthetists require education on herbal medicines. Suggestions for remedial action are given.