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Table 3 Recommendations and implications of natural product use as related to preoperative concerns.

From: Evaluation and implications of natural product use in preoperative patients: a retrospective review

Natural Product

Evidence based Recommendations:

Discontinuation of natural products prior to surgery

Perioperative Concerns

Fish Oil

2-3 weeks prior to surgery [15]

Perioperative bleeding [15, 20] Hypotension [20]

Glucosamine

2-3 weeks prior to surgery [15]

Hypoglycemia [15, 19]

Garlic

1 week [15, 16] At least 2 weeks [22]

Perioperative bleeding [9, 13, 15–17, 19–22]

Hypotension [9, 15, 16, 19, 20]

Flax Seed

No specific recommendations

Perioperative bleeding [18]

Coenzyme Q-10

(ubiquinone)

No specific recommendations

Hypotension [20]

Cardiac effects [20]

Perioperative bleeding effects [21]

Saw palmetto

2-3 weeks prior to surgery [15]

Perioperative bleeding [9, 15]

Tachycardia [9]

Angina [9]

Water/electrolyte disturbances [19]

Ginseng

At least 7 days [13, 15] At least 2 weeks [22]

Hypoglycemia [9, 13, 15–17, 19]

Hypertension [9, 13, 15, 16]

Perioperative bleeding [9, 13, 15, 17, 19–22]

Tachycardia [9, 13]

Water/electrolyte disturbances [19]

Prolongation of anesthetic effects [19]

Chondroitin

2-3 weeks prior to surgery [15]

Perioperative bleeding [15, 19]

Milk Thistle

2-3 weeks prior to surgery [15]

Volume depletion [15]

Green Tea

No specific recommendations

Perioperative bleeding [18, 21]

Cardiovascular side-effects [18, 21]

Water/electrolyte disturbances [19]