Steroids and the surgical patient.
In patients undergoing surgery, a thorough history is important to obtain, including use of any steroid therapy within the previous year. If there is a history of steroid use, and if time permits, testing of the HPA axis should be performed. If adrenal unresponsiveness is documented or if clinical suspicion of [table: see text] adrenal insufficiency is high (without testing), a stress dose of steroids should be administered during the perioperative period to prevent an adrenal crisis.
Jabbour
S A
SA
Department of Medicine, Division of Endocrinology, Diabetes, and Metabolic Diseases, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA. serge.jabbour@mail.tju.edu
D000328:Adult; D003907:Dexamethasone / Q000494:pharmacology; D003940:Diagnostic Techniques, Endocrine; D005260:Female; D005938:Glucocorticoids / Q000494:pharmacology*; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects* / Q000502:physiology; D010048:Ovarian Cysts / Q000601:surgery; D010913:Pituitary-Adrenal System / Q000187:drug effects* / Q000502:physiology; D013312:Stress, Physiological / Q000503:physiopathology*; D013514:Surgical Procedures, Operative
D005938:Glucocorticoids; D003907:Dexamethasone