Date of Award

4-2012

Document Type

Independent Study

Degree Name

Master of Science (MS)

Abstract

A concern for anesthesia providers is the risk of perioperative shock due to secondary adrenal insufficiency in patients receiving long-term glucocorticoid therapy who do not receive supplemental stress steroid coverage for surgery. Dexamethasone is currently used by anesthesia providers as a perioperative anti-inflammatory agent and as an antiemetic adjunct. Hydrocortisone is currently the most commonly used drug for bridging patients who have previously received long tem1 glucocorticoid therapy. The increased potency, duration of action, and antiemetic properties of dexamethasone may make it a desirable substitution for hydrocortisone . The purpose of this independent project was to review the current literature investigating whether the substitution of dexamethasone for the hydrocortisone standard would reduce the need for re-dosing of glucocorticoids. A comprehensive review of the literature was performed using PubMed and CINAHL databases. Current research findings on the topic of interest and related topics were reviewed. Relevant articles were reviewed along with their reference sections. Even though dexamethasone has many desirable properties, further research is needed for practitioners to safely bridge patients with dexamethasone. Many pharmacologic properties of dexamethasone have been identified to date, and the current use of the drug is ever changing as new studies confirm increasing beneficial effects. Anesthesia providers can take the pharmacologic properties of dexamethasone into consideration when formulating an anesthetic plan. Some properties may make it an attractive alternative to hydrocortisone and it may reduce the need for redosing of glucocorticoid

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