Preop steroids may cut asthmatics' complications. (Regimen Appears Safe).

DENVER -- Corticosteroids can safely be given to asthmatics before surgery to improve lung function and reduce pulmonary complications, Dr. Fanny W Su said at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

In a series of 240 surgeries on 172 asthmatic patients given preoperative corticosteroids, postoperative bronchospasm occurred in 13 cases (5%), a retrospective study found. Most of the patients also got intravenous steroids during the surgery. Historic data in the medical literature report that without corticosteroids before or during surgery up to 11% of asthmatic patients may develop postoperative pulmonary complications, said Dr. Su of Northwestern University Chicago.

Although there are no data showing that adding preoperative corticosteroids to intraoperative steroids lowers the rate of pulmonary complications, compared with giving intraoperative steroids alone, "we feel the few days of oral steroids prior to surgery are of added benefit to intravenous steroids in optimizing the respiratory status," she said.

A National Heart, Lung, and Blood Institute expert panel in 1997 recommended that asthmatic patients who have used corticosteroids for more than 2 weeks during the 6 months before surgery be given intraoperative IV cortisone 100 mg every 8 hours, with the dose rapidly reduced within 24 hours following surgery Chronic use of corticosteroids can cause adrenal insufficiency, limiting a patient's ability to produce the extra steroids the body needs to handle the stress of surgery Giving steroids during surgery is meant to protect any patients who may have steroidrelated adrenal insufficiency and are unable to produce sufficient quantities of the hormone on their own, she explained.

Most patients in the current study received ...