Published in:
01-12-2018 | Correspondence
Perioperative glucocorticoid stress dosing: a survey of anesthesiologists and general internists
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 12/2018
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To the Editor,
Table
Perioperative GC management for clinical cases
|
Preoperative oral prednisone treatment
|
ANs
|
GIMs
|
||
|---|---|---|---|---|
|
Daily dose (mg)
|
Duration
|
(n = 295)
|
(n = 145)
|
|
|
82-yr-old male with COPD
Undergoing open cholecystectomy
|
40 mg
|
5 days, finished 1 week ago
(COPD exacerbation)
|
No perioperative GC
166 (56%)
|
No perioperative GC
110 (76%)
|
|
66-yr-old female with prior liver transplant
Undergoing total knee replacement
|
5 mg
|
7 years
|
Usual GC dose day of surgery
No additional GC
144 (49%)
|
HC 50 mg iv, then HC 25 mg iv every 8 hr
for 24-48 hr
87 (60%)
|
|
38-yr-old male with Ulcerative colitis and asthma
Undergoing inguinal hernia repair (spinal anesthesia)
|
20 mg
|
6 months
|
Usual GC dose day of surgery
No additional GC
158 (54%)
|
Usual GC dose day of surgery
No additional GC
58 (40%)
|
|
38-yr-old male with Ulcerative colitis and asthma
Undergoing total colectomy
|
20 mg
|
6 months
|
HC 100 mg iv, then HC 50 mg iv every 8 hr for 24 hr
Taper dose by half per day to home dose
97 (33%)
|
HC 100 mg iv, then HC 50 mg iv every 8 hr
For 24 hr
Taper dose by half per day to home dose
44 (30%)
|
|
67-yr-old male with prior kidney transplant
Undergoing lobectomy for early-stage NSCLC
|
5 mg
|
5 years
|
HC 100 mg iv, then HC 50 mg iv every 8 hr for 48 hr
Taper dose by half per day to home dose
108 (37%)
|
HC 100 mg iv, then HC 50 mg iv every 8 hr
For 24 hr
Taper dose by half per day to home dose
47 (32%)
|