A 30 year old female who is known case of lupus is posted for myomectomy. She has been taking 20 mg prednisolone since she was 19. what is your advice regarding perioperative steroid replacement
Patients on long term steroid therapy need not stop dose on day of surgery.
Stop steroids the night before this procedure
Give 20 mg prednisolone on the morning of the procedure
Replace with 100 mg hydrocortisone on the morning of the procedure
Do adrenal function test prior to procedure to decide on tapering the dose.