In patients on long-term corticosteroid therapy, what is a common preoperative consideration?

In patients undergoing long-term corticosteroid therapy, a common preoperative consideration is to increase the steroid dosage. This is particularly important because prolonged use of corticosteroids can suppress the adrenal glands, leading to a decreased production of endogenous corticosteroids. During surgery or periods of stress, the body typically requires increased levels of cortisol to manage the physiological demands. Therefore, if a patient is already on long-term corticosteroids, the standard practice is to adjust their medication to ensure adequate steroid coverage.

Maintaining the current dosage might not suffice as the body may require more than usual during the stress of surgery. Discontinuing the medication is generally not advisable due to the risk of adrenal insufficiency. Additionally, reducing hydration does not address the underlying need for adequate corticosteroid levels in the context of surgical stress. Thus, increasing the steroid dosage is crucial to prevent complications and support the body's response during the perioperative period.