PERIOPERATIVE STEROID USE IN COLORECTAL PATIENTS - RESULTS OF A SURVEY

PURPOSE: A survey was conducted to document current perioperative ster oid use in colorectal patients. METHODS: A mail survey was sent to 1,4 00 members and fellows of The American Society of Colon and Rectal Sur geons. RESULTS: Three hundred seven questionnaires (21.9 percent) were returned. Twenty-four respondents had retired or lacked accurate data . The remaining 283 surgeons averaged 43.5 (range, 31-71) pears in age and had been in practice an average of 11 (range, 1-39) years. Ninety -seven percent were certified by the American Board of Surgery, 87 per cent by the American Board of Colon and Rectal Surgery, and 85 percent by both. Eighty-six percent of respondents manage the perioperative s teroids and 85 percent manage the postoperative steroid taper of their patients. In patients receiving preoperative steroids, 84 percent of respondents administer 100 mg of hydrocortisone phosphate intravenousl y before surgery. The most common postoperative dosage (used by 62 per cent) was 100 mg of hydrocortisone phosphate intravenously every eight hours, which was tapered to 50 mg intravenously every 8 to 12 hours. Most patients (49 percent) received 20 mg of prednisone per day when t heir oral intake was resumed. The most common taper regimen was a 5 mg reduction per week (61 percent of respondents). CONCLUSION: Despite l ack of scientifically established requirements or proven physiologic g uidelines, perioperative steroid use by colorectal surgeons appears re latively consistent.