Norred C L, Zamudio S, Palmer S K
School of Nursing, University of Colorado Health Sciences Center, Denver, USA.
AANA J. 2000 Feb;68(1):13-8.
This study examined the frequency of surgical patient use of complementary and alternative medicines prior to surgery. After conducting a literature review on the known effects of alternative medicines, we evaluated their potential interactions with anesthetics. At the University of Colorado Health Sciences Center, Denver, Colo, we surveyed 500 elective surgical outpatients about alternative medicines taken during the 2 weeks prior to surgery. Of the 500 patients surveyed, 51% preoperatively took herbs, vitamins, dietary supplements, or homeopathic medicines (range, 1-22 per patient). Substances from 2 or more categories of alternative medicines (herbs, vitamins, dietary supplements, or homeopathic medicines) were consumed by 24% of patients. Twenty-four percent of surveyed patients consumed 50 different herbs, 41% took 9 types of vitamins, 44% took 31 types of dietary supplements, and 1% of patients took the homeopathic arnica. Classification by potential adverse effects revealed that 27% of surgical patients consumed alternative medicines that may inhibit coagulation, affect blood pressure (12%), cause sedation (9%), have cardiac effects (5%), or alter electrolytes (4%). Greater communication, knowledge, and scientific research are needed to safely integrate complementary and alternative medicines in the future management of the surgical patient.
本研究调查了外科手术患者术前使用补充和替代药物的频率。在对替代药物的已知作用进行文献综述后，我们评估了它们与麻醉剂的潜在相互作用。在科罗拉多大学健康科学中心（位于科罗拉多州丹佛市），我们对500名择期手术门诊患者进行了调查，询问他们在手术前2周内服用的替代药物情况。在接受调查的500名患者中，51%在术前服用了草药、维生素、膳食补充剂或顺势疗法药物（每位患者服用的种类为1至22种）。24%的患者服用了来自2种或更多类别的替代药物（草药、维生素、膳食补充剂或顺势疗法药物）。24%的受调查患者服用了50种不同的草药，41%服用了9种维生素，44%服用了31种膳食补充剂，1%的患者服用了顺势疗法的山金车属植物。按潜在不良反应分类显示，27%的外科手术患者服用的替代药物可能会抑制凝血、影响血压（12%）、引起镇静作用（9%）、产生心脏影响（5%）或改变电解质（4%）。未来在外科手术患者的管理中安全整合补充和替代药物，需要加强沟通、提高认识并开展更多科学研究。
