The effects of valerian on the time course of emergence from general anesthesia in Sprague-Dawley rats, December 2007 AANA Journal

AANA Journal/December 2007/Vol. 75, No. 6 431 system, also found in valerian, are believed to be responsible for most biological effects of valerian by inhibiting the breakdown or enhancing the effect of GABA in the brain, producing sedation. No study to date has evaluated the effects of valerian or the combination of valerian and midazolam, a commonly used preanesthetic anxiolytic, on emergence time from general anesthesia in animals or humans. The popularity of herbal medicines such as valerian may have substantial implications for healthcare professionals, specifically anesthesia providers. For example, only about 40% of patients inform their physicians of their use of alternative medicines. Furthermore, more than 15 million people take prescription medications concurrently with herbal medications and/or high-dose vitamins. This may present substantial potential for adverse interactions between anesthetics and herbal medications. The purpose of this study was to investigate the Herbal use may be associated with increased morbidity and mortality as a consequence of interactions with anesthetic agents. The purpose of this study was to investigate the effects on emergence from isoflurane anesthesia using a combination of the herb valerian and midazolam compared with valerian alone, midazolam alone, and no additional drug-herb treatment in Sprague-Dawley rats. We assigned 32 male Sprague-Dawley rats to 1 of 4 groups: (1) isoflurane alone, (2) isoflurane plus valerian, (3) isoflurane plus midazolam, and (4) isoflurane plus a combination of valerian and midazolam. Thirty minutes after treatment, animals underwent a standard laparotomy. The time in seconds from discontinuation of isoflurane to the time the animal righted itself and took 1 step was recorded as emergence time. A 1-way analysis of variance with a post hoc Scheffe procedure revealed that animals given a combination of midazolam and valerian took significantly longer to emerge from anesthesia (F = 58.21; P < .00) compared with all other groups. Awareness of possible interactions of herbals with conventional anesthetics is important so that potential problems may be recognized and treated. These data demonstrate the need for continued research concerning the effects of herbals and their potential for interaction with anesthetics.