How is steroid therapy adjusted during and after surgical procedures in Addison disease?

Updated: Mar 11, 2020
  • Author: George T Griffing, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

During surgical procedures, 100 mg of hydrocortisone should be given, preferably by the IM route, prior to the start of a continuous IV infusion. The IM dose of hydrocortisone assures steroid coverage in case of problems with the IV access.

  • When continuous IV infusion is not practical, an intermittent IV bolus injection every 6-8 hours may be used.

  • After the procedure, the hydrocortisone may be rapidly tapered within 24-36 hours to the usual replacement doses, or as gradually as the clinical situation dictates.

  • Mineralocorticoid replacement usually can be withheld until the patient resumes daily replacement steroids.


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