Updates in medicine

Achives of Surgery
2008;143(12):1222-1226
Requirement of perioperative stress doses of corticosteroids: a systemic review
• Patients receiving therapeutic doses of corticosteroids undergoing surgical procedure do not routinely require stress doses of corticosteroids as long as they continue their usual daily dose of corticosteroids.
• Adrenal function testing is not required in these patients because the test is overly sensitive and can’t predict which pt will develop an adrenal crisis.
• However, patients receiving physiological doses owing to hypothalamic-pituitary-adrenal axis d/o require supplemental doses of corticosteroids in the perioperative period.