| Category
|
Initial
|
Subsequent
|
| Minor procedure or surgery under local anesthesia (eg, inguinal hernia repair) |
No extra supplementation is necessary |
Continue normal dosing
|
| Moderate surgical stress (eg, lower extremity revascularization, total joint replacement) |
50 mg hydrocortisone IV |
25 mg of hydrocortisone every eight hours for 24 hours. Resume usual dose thereafter.
|
| Major surgical stress (eg, esophagogastrectomy, total proctocolectomy, open heart surgery) |
100 mg hydrocortisone IV |
50 mg every eight hours for 24 hours. Taper dose by half per day to maintenance level.
|
