Understanding Anesthesiology - The Global Regional Anesthesia ...

Addisonian crisis
Addisonian crisis comprises a constellation of symptoms, including severe hypotension and
coma, that results from marked adrenal insufficiency.
In the peri-operative period, Addisonian crisis can occur in a patient who has chronic adrenal
suppression due to (taking) exogenous systemic corticosteroids. Even if the patient’s
“normal” steroid regime is continued, it may not be adequate to meet the increased demands
created by the stress of surgery. In this case, Addisonian crisis may be seen. Prevention
centres on providing adequate steroid coverage perioperatively. Duration of coverage
depends on the magnitude of the surgery. A single pre-operative dose is sufficient for minor
surgery, while 72 hours of coverage is required for major surgery.
Related Glossary Terms
Adrenal suppression, Pre-medication
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Chapter 2 - Pre-operative Evaluation