KEY POINTS

1. Despite lack of federal oversight, herbal medication use has increased dramatically in the overall population and particularly in preoperative patients.
2. Patients may not volunteer information unless they are specifically queried about herbal medication use.
3. Many commonly used herbs have side effects that affect drug metabolism, bleeding, and neuronal function.
4. Although stopping herbs up to 2 weeks preoperatively can eliminate many of these problems, patients often present for surgery without a visit 2 weeks before surgery. Knowledge of specific interactions and metabolism of these herbs can provide practical guidelines to facilitate care.
5. Other complementary therapies, including acupuncture and music therapy, have become increasingly popular, although less is known about their effectiveness.