Table 3.148.

Alternative management of patients with a history of systemic corticosteroid therapy (Gibson and Ferguson 2004)

Amount of steroid (prednisolone or equivalent) taken (currently or within 2 months)	Type of surgery	Steroid supplementation
<10 mg per day	All procedures	Do not warrant supplementation
10–50 mg per day*	Surgical procedures under LA	Double the usual steroid dose on the day
	Surgical procedure under GA	Minor surgery: 100 mg hydrocortisone IM preop Major surgery: 100 mg hydrocortisone IM preop followed by 50 mg 8-hourly for 48 h

^*Patients taking more than 50 mg prednisolone are close to the innate maximum cortisol level seen in patients when stressed and do not require steroid supplementation.