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REVIEW ARTICLE
Year : 2019  |  Volume : 35  |  Issue : 2  |  Page : 147-152

Perioperative “stress dose” of corticosteroid: Pharmacological and clinical perspective


Department of Anesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Shahdara, New Delhi, India

Correspondence Address:
Geetanjali T Chilkoti
A-1404, Jaipuria Sunrise Greens, Ahimsa Khand, Indirapuram, Ghaziabad - 201 014, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joacp.JOACP_242_17

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Various exogenous steroid preparations have been in use for a wide range of indications. We, as an anesthesiologist often encounters a surgical patient receiving chronic steroid therapy. Perioperative use of steroid is associated with major complications such as full-blown adrenal crisis in the perioperative period due to the secondary adrenal insufficiency. Henceforth, comes the role of the perioperative “stress-dose” of steroids to mitigate this rare but potentially fatal complication. There have been opposing views regarding the need and the appropriate dosage of the perioperative steroids. The present review discusses the changing concept of perioperative “stress dose” of corticosteroids, its pharmacokinetics, clinical relevance, and the related controversies such as the need and the appropriate dose.


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