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Steroids: The Evidence. The Rationale for Perioperative Glucocorticoid Supplementation for Patients Under Chronic Steroid Treatment

  • Pediatric Anesthesia (J Lerman, Section Editor)
  • Published:
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Abstract

Perioperative steroid supplementation for patients taking chronic glucocorticoid medication is considered standard of care. The aim of this submission is to present strategies to avoid the occurrence of acute adrenal insufficiency (AAI), a potentially fatal complication described in several case reports. However, doubts remain regarding the clinical relevance of this practice. AAI is described in the literature as a rare phenomenon, and there is little evidence that its incidence is reduced by administering supplemental steroids. On the other hand, plasma cortisol plays a critical role in the maintenance of hemodynamic stability during surgery-induced stress response. This review will provide an overview of the pediatric recommendations that have been published on perioperative steroid supplementation and detail the evidence-based rationale in favor of this practice.

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  1. Service d’Anesthésie-Réanimation chirurgicale, Hôpital d’enfants Armand Trousseau, AP-HP, UPMC, Paris VI, 26 av. du Dr Arnold Netter, 75012, Paris, France

    Nada Sabourdin

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Correspondence to Nada Sabourdin.

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Sabourdin, N. Steroids: The Evidence. The Rationale for Perioperative Glucocorticoid Supplementation for Patients Under Chronic Steroid Treatment. Curr Anesthesiol Rep 5, 140–146 (2015). https://doi.org/10.1007/s40140-014-0093-2

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