Herbal and homeopathic medication use in pediatric surgical patients.
BACKGROUND
Patients who present for surgery may be using herbal or homeopathic preparations; adverse effects of some of these substances include bleeding, cardiovascular changes, and liver dysfunction. Little information is available on the frequency of use in the pediatric surgical population.


METHODS
With institutional approval, a survey was conducted to assess the use of vitamins, nutritional supplements, or herbal or homeopathic preparations in children presenting for surgery in five geographically diverse centers in the USA.


RESULTS
A total of 894 completed surveys showed that overall, 3.5% of pediatric surgical patients had been given herbal or homeopathic medications in the 2 weeks prior to surgery. Most substances were prescribed by parents. The use of these medications did not differ between children with coexisting diseases and those without; use was also not different among ethnic groups or by residence setting (city, suburban, rural). There was a significant difference between the west coast centers in the study compared with the rest of the country (7.5% of patients in Palo Alto, CA; 5.5% of patients in Seattle, WA; 1.5% of patients in Chicago, IL; and 1.9% in Virginia and Delaware used herbal or homeopathic remedies). The most prevalent substance given to children presenting for elective surgery was Echinacea.


CONCLUSIONS
Herbal and homeopathic medications are used by a small percentage of pediatric patients presenting for elective pediatric surgery patients. Use of these substances should be addressed in the preoperative history.
Everett
Lucinda L
LL
Department of Anesthesiology, Children's Hospital and Regional Medical Center, University of Washington, USA. lucyeverett@comcast.net
Birmingham
Patrick K
PK
Williams
Glyn D
GD
Brenn
B Randall
BR
Shapiro
Jay H
JH
D000293:Adolescent; D000758:Anesthesia; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003625:Data Collection; D019587:Dietary Supplements / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures; D005260:Female; D006705:Homeopathy / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D008517:Phytotherapy / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology