Dietary Supplements and Postoperative Bleeding

Sung Yong Choi; Mi-Kyung Ye

doi:10.18787/jr.2015.22.2.63

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Choi and Ye: Dietary Supplements and Postoperative Bleeding

Original Article

J Rhinol 2015;22(2):63-68.

Published online: 10 January 2015

DOI: https://doi.org/10.18787/jr.2015.22.2.63

Dietary Supplements and Postoperative Bleeding

Sung Yong Choi, MD, Mi-Kyung Ye, MD

Department of Otorhinolaryngology-Head and Neck Surgery, Catholic University of Daegu, School of Medicine, Daegu, Korea

교신저자：예미경, 42472 대구광역시 남구 두류공원로 17길 33 대구가톨릭대학교 의과대학 이비인후과학교실Tel: +82-53-650-4525, Fax: +82-53-650-4533, E-mail: miky@cu.ac.kr

Received 23 June 2015 Revised 12 August 2015 Accepted 9 September 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

There is a wide variety of dietary supplements on the market that are taken by patients of all walks of life. Unfortunately their use is self-prescribed and patients rarely view them as medication reveal their use to hospital staff. Garlic has been reported to inhibit platelet aggregation and may interact with anticoagulants and antiplatelet agents. Other alternative supplements have also been associated with potential increased bleeding, including ginkgo biloba, ginger, ginseng, and omega-3 fatty acid. It is essential for surgeons to be apprised of all substances ingested by patients, so they can identify potential adverse effects and drug interactions.

Keywords: Dietary supplements, Postoperative hemorrhage, Herbal medicine.

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Fig. 1.

Number of natural products taken per patient (adapted from reference #1).

Fig. 2.

The arachidonic acid cascade.

Table 1.

Pharmacological effects and perioperative cautions of dietary supplements and recommendations for discontinuation of use before surgery

Dietary supplements	Common uses (marketing)	Pharmacological effects	Surgical caution	Preoperative discontinuation
Garlic	Anti-inflammatory	Inhibition of platelet aggregation	Perioperative	At least 7 days
Allium sativum	Antihypertensive	(dose-dependent)	bleeding	before surgery
	Lipid-lowering	Increased fibrinolysis
	Antithrombotic	Lowers serum lipid and cholesterol levels
Ginko	Imporve cognitive deficits	Inhibition of platelet activating	Perioperative	At least 36 hours
Ginko biloba	Circulatory stimulant	factor	bleeding	before surgery
	Used to treat	Inhibition of platelet aggregation
	Alzheimer's disease, peripheral vascular disease, tinnitus	Decreased plasma viscosity, erythrocyte aggregation	Postoperative sedation
	Antioxidant	Modulates neurotransmitter activity
Ginseng	Cancer prevention	Inhibition of platelet aggregation	Perioperative	At least 7 days
Panax ginseng	Blood glucose-lowering	Similar mechanism to steroid	bleeding	before surgery
Panax	Protect the body against	hormones	Hypertension
quinquefolius	stress and restore homeostasis		Hypoglycemia
Ginger	Anti-inflammatory	Inhibition of platelet aggregation	Perioperative	At least 14 days
Zingiber officinale	Antiemetic	Direct stimulation of the gastrointestinal tract, or serotonin antagonism in the gut or central nervous system	bleeding	before surgery
Omega-3 fatty acid	Antithrombotic	Inhibition of platelet aggregation	Perioperative	At least 14 days
Fish oil	Cardioprotective	Inhibition of platelet activating	bleeding	before surgery
	Antihypertensive	factor
	Lipid-lowering	Decreased plasma viscosity Increased erythrocyte membrane fluidity

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