Resuming corticosteroid therapy following a surgical procedure requires careful consideration and individualized planning. The timing depends on several factors, including the type of surgery, the patient’s pre-operative corticosteroid dose, the extent of surgical stress, and the risk of adrenal insufficiency. For example, a patient on a high dose of prednisone before surgery might require intravenous corticosteroids during and immediately after the procedure, with a gradual transition back to their pre-surgical dose. Conversely, a patient on a low dose might be able to resume their usual regimen shortly after surgery.
Appropriate management of perioperative steroid therapy is critical for preventing complications such as adrenal crisis, wound healing problems, and increased susceptibility to infections. Historically, surgical patients taking corticosteroids were at significant risk of adrenal insufficiency due to the suppression of the hypothalamic-pituitary-adrenal (HPA) axis. Advances in understanding steroid pharmacology and improved surgical techniques have reduced these risks, but careful monitoring and individualized management remain essential. A well-defined plan minimizes potential adverse events and promotes optimal surgical outcomes.
