Norred Carol L
Department of Anesthesiology, University of Colorado Health Sciences Center (UCHSC), Denver, Colo., USA.
AANA J. 2002 Apr;70(2):119-25.
This study investigated the use of complementary and alternative medicines by surgical patients at the University of Colorado Health Sciences Center, Denver. Elective surgical outpatients were randomly surveyed with anonymous self-report questionnaires during day-surgery admission about alternative medicines taken during the 2 weeks before surgery; 496 of 500 questionnaires were completed and returned. Of the patients, 37% reported 62 types of herbs, 59% reported 14 types of vitamins, 45% reported 36 types of of dietary supplements, and 1% reported taking 5 types of homeopathics. A total of 73.4% of patients took alternative medicines preoperatively (range, 1-44 medicines). After a literature review, the alternative medicines were categorized for potential interactions with anesthetic drugs. Alternative medicines that have inhibitory effects on the coagulation cascade were reported by 40% of surgical patients. The following percentages of patients took medicines that affect blood pressure, 32%; affect cardiac function, 20%; cause sedation, 17%; or have potential to alter electrolyte levels, 9%. Herbs recognized to interact with pharmaceuticals were consumed by 23% of patients. Further research, education, and improved communication are needed to safely integrate alternative medicines for surgical patients.
本研究调查了丹佛市科罗拉多大学健康科学中心外科手术患者使用补充和替代药物的情况。在日间手术入院时,对外科择期门诊患者进行了随机调查,采用匿名自填问卷的方式询问他们在手术前两周内服用的替代药物;500份问卷中有496份填写并返回。在这些患者中,37%报告使用了62种草药,59%报告使用了14种维生素,45%报告使用了36种膳食补充剂,1%报告服用了5种顺势疗法药物。共有73.4%的患者在术前服用了替代药物(范围为1至44种药物)。经过文献综述,对这些替代药物与麻醉药物的潜在相互作用进行了分类。40%的外科手术患者报告使用了对凝血级联有抑制作用的替代药物。服用影响血压药物(32%患者)、影响心脏功能药物(20%患者)、引起镇静作用药物(17%患者)或有改变电解质水平可能药物(9%患者)的患者比例如下。23%的患者服用了已知与药物相互作用的草药。为了安全地将替代药物纳入外科手术患者的治疗方案,需要进一步的研究、教育和更好的沟通。