steroid

Question 1

steroid cover for peri op if patient on chronic t prednisolone 15mg od for asthma

Answer 1

t pred > 10mg per day
->ADRENAL atrophy
-> if abrupt withdrawal-> acute adrenal insufficiency

minor op
-usual oral dose
-or iv hydrocort 25-50mg at induction

mod-major op
-usual oral dose +
-iv hydrocort 25mg at induction followed by
- mod surg -iv hydrocort 25mg tds x 24hrs
- major surg- -iv hydrocort 25mg tds x 48-72h