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Chapter: Clinical Cases in Anesthesia : Perioperative Corticosteroid Administration

Perioperative Corticosteroid Administration

A 68-year-old man presents for a laparoscopic cholecystectomy.

PERIOPERATIVE CORTICOSTEROID ADMINISTRATION


A 68-year-old man presents for a laparoscopic cholecystectomy. He has been taking prednisone 10 mg per day for the treatment of polymyalgia rheumatica. He has no other medical history.

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Clinical Cases in Anesthesia : Perioperative Corticosteroid Administration : Perioperative Corticosteroid Administration |

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Clinical Cases in Anesthesia : Perioperative Corticosteroid Administration
Perioperative Corticosteroid Administration
Where and what kind of steroids are naturally produced?
What are the physiologic effects of glucocorticosteroids?
What steroids are available for administration and what are their equivalent doses?
How much cortisol is normally produced and what is Addison’s disease?
What are Cushing syndrome and Cushing disease?
Does this patient require “stress” dose steroids?
How long after discontinuation of steroids should a patient be considered adrenally suppressed and treated accordingly?
What clinical scenarios frequently require steroid administration?
How is adrenal reserve evaluated?
If this patient develops septic shock from a bile leak in the postanesthesia care unit (PACU), should steroids be withheld or administered?


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