Does this patient require “stress” dose steroids?
Laparoscopic cholecystectomy without surgical
compli-cation, such as large blood loss, will usually not result in any
significant increase in endogenous cortisol production. Therefore, the
administration of full dose “stress” steroids (i.e., hydrocortisone 100 mg
intravenously every 8 hours) is not indicated for this patient. However, most
sources recommend a modest increase in steroid administration. For example, the
patient may be instructed to take pred-nisone 10 or 15 mg orally on the day of
surgery, and perhaps the day after, or the equivalent dose of another steroid.
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