They explain what level of extra medication and monitoring you will need in the event of different types of surgery or dental work. If you are having elective surgery or an invasive procedure in hospital, for example, a hip operation, a colonoscopy it would be sensible to give your specialist consultant and anaesthetist a copy of the guidelines well in advance of your surgery date. It is also advisable to take the guidelines with you when you go in to hospital and discuss them with your nursing staff, so that they are aware of the post-operative care you need. You can order a complete set of hospital documentation, including copies of the nurses leaflet and steroid alert stickers, from The Shop here...

These guidelines:

a. List the ten main types of surgical procedure, each requiring a different level of peri-operative steroid cover

b. Specify the glucocorticoid medication and post-operative treatment requirements for each type of procedure in an easy-to-read table

c. Bring together on the timing and the most efficient route for administration of steroid cover during the stress of surgical procedures.

d. Suggest a risk-free level of steroid cover, that should be sufficient for a patient with additional health complications.

These guidelines apply to all individuals who are steroid-dependent, so they are relevant to people with secondary adrenal suppression or hypopituitarism as well as those with primary adrenal loss (Addison's).

The leaflet is © ADSHG March 2006. It may be copied for personal use or by medical practitioners for the education of their patients. Otherwise it should not be reproduced without written permission of the ADSHG.