Perioperative glucocorticoid management based on current evidence
Glucocorticoid preparations, adreno-cortical steroids, with strong anti-inflammatory and immunosuppressive effects, are widely used for treating various diseases. The number of patients exposed to steroid therapy prior to surgery is increasing. When these patients present for surgery, the anesthesio...
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Anesthesiologists
2021-01-01
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| Series: | Anesthesia and Pain Medicine |
| Subjects: | |
| Online Access: | http://www.anesth-pain-med.org/upload/pdf/apm-20089.pdf |
| _version_ | 1827946128108158976 |
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| author | Kwon Hui Seo |
| author_facet | Kwon Hui Seo |
| author_sort | Kwon Hui Seo |
| collection | DOAJ |
| description | Glucocorticoid preparations, adreno-cortical steroids, with strong anti-inflammatory and immunosuppressive effects, are widely used for treating various diseases. The number of patients exposed to steroid therapy prior to surgery is increasing. When these patients present for surgery, the anesthesiologist must decide whether to administer perioperative steroid supplementation. Stress-dose glucocorticoid administration is required during the perioperative period because of the possibility of failure of cortisol secretion to cope with the increased cortisol requirement due to surgical stress, adrenal insufficiency, hemodynamic instability, and the possibility of adrenal crisis. Therefore, glucocorticoids should be supplemented at the same level as that of normal physiological response to surgical stress by evaluating the invasiveness of surgery and inhibition of the hypothalamus-pituitary-adrenal axis. Various textbooks and research articles recommend the stress-dose of glucocorticoids during perioperative periods. It has been commonly suggested that glucocorticoids should be administered in an amount equivalent to about 100 mg of cortisol for major surgery because it induces approximately 5 times the normal secretion. However, more studies, with appropriate power, regarding the administration of stress-dose glucocorticoids are still required, and evaluation of patients with possible adrenal insufficiency and appropriate glucocorticoid administration based on surgical stress will help improve the prognosis. |
| first_indexed | 2024-03-13T10:53:19Z |
| format | Article |
| id | doaj.art-64cbd2442e9f49f0b10b88316b4a58ca |
| institution | Directory Open Access Journal |
| issn | 1975-5171 2383-7977 |
| language | English |
| last_indexed | 2024-03-13T10:53:19Z |
| publishDate | 2021-01-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Anesthesia and Pain Medicine |
| spelling | doaj.art-64cbd2442e9f49f0b10b88316b4a58ca2023-05-17T05:44:26ZengKorean Society of AnesthesiologistsAnesthesia and Pain Medicine1975-51712383-79772021-01-0116181510.17085/apm.200891057Perioperative glucocorticoid management based on current evidenceKwon Hui Seo0 Department of Anesthesiology and Pain Medicine, Hallym University Sacred Heart Hospital, Hallym University School of Medicine, Anyang, KoreaGlucocorticoid preparations, adreno-cortical steroids, with strong anti-inflammatory and immunosuppressive effects, are widely used for treating various diseases. The number of patients exposed to steroid therapy prior to surgery is increasing. When these patients present for surgery, the anesthesiologist must decide whether to administer perioperative steroid supplementation. Stress-dose glucocorticoid administration is required during the perioperative period because of the possibility of failure of cortisol secretion to cope with the increased cortisol requirement due to surgical stress, adrenal insufficiency, hemodynamic instability, and the possibility of adrenal crisis. Therefore, glucocorticoids should be supplemented at the same level as that of normal physiological response to surgical stress by evaluating the invasiveness of surgery and inhibition of the hypothalamus-pituitary-adrenal axis. Various textbooks and research articles recommend the stress-dose of glucocorticoids during perioperative periods. It has been commonly suggested that glucocorticoids should be administered in an amount equivalent to about 100 mg of cortisol for major surgery because it induces approximately 5 times the normal secretion. However, more studies, with appropriate power, regarding the administration of stress-dose glucocorticoids are still required, and evaluation of patients with possible adrenal insufficiency and appropriate glucocorticoid administration based on surgical stress will help improve the prognosis.http://www.anesth-pain-med.org/upload/pdf/apm-20089.pdfadrenal glandsadrenal insufficiencyglucocorticoidshypothalmuperioperative periodpituitary glandsteroid |
| spellingShingle | Kwon Hui Seo Perioperative glucocorticoid management based on current evidence Anesthesia and Pain Medicine adrenal glands adrenal insufficiency glucocorticoids hypothalmu perioperative period pituitary gland steroid |
| title | Perioperative glucocorticoid management based on current evidence |
| title_full | Perioperative glucocorticoid management based on current evidence |
| title_fullStr | Perioperative glucocorticoid management based on current evidence |
| title_full_unstemmed | Perioperative glucocorticoid management based on current evidence |
| title_short | Perioperative glucocorticoid management based on current evidence |
| title_sort | perioperative glucocorticoid management based on current evidence |
| topic | adrenal glands adrenal insufficiency glucocorticoids hypothalmu perioperative period pituitary gland steroid |
| url | http://www.anesth-pain-med.org/upload/pdf/apm-20089.pdf |
| work_keys_str_mv | AT kwonhuiseo perioperativeglucocorticoidmanagementbasedoncurrentevidence |