Steroid injection pre/post surgery

[oneforfighting]

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What's your thought process for a patient on whom you want to do a steroid injection but is also scheduled to undergo surgery? For example, patient has foot surgery scheduled next month. Do you do an epidural now? Is there a period of time you wait post-op to do an injection?
Is there any literature to support increased risk for doing steroid injection on a separate location than site of surgery? I know that doing an injection at the site of surgery (i.e. hip) pre-op increases risk of surgical infection.

 

[willabeast]

What's your thought process for a patient on whom you want to do a steroid injection but is also scheduled to undergo surgery? For example, patient has foot surgery scheduled next month. Do you do an epidural now? Is there a period of time you wait post-op to do an injection?
Is there any literature to support increased risk for doing steroid injection on a separate location than site of surgery? I know that doing an injection at the site of surgery (i.e. hip) pre-op increases risk of surgical infection.

Ask the surgeon his/her preference. It does not matter much what the literature says. The surgeon is the one who decides if operating.

 

[kstarm]

Ask the surgeon his/her preference. It does not matter much what the literature says. The surgeon is the one who decides if operating.

This. You don't want to inadvertently postpone a surgery even if risk/literature would support the injection.

 

[oneforfighting]

Ask the surgeon his/her preference. It does not matter much what the literature says. The surgeon is the one who decides if operating.

Would you get actual paperwork clearance from the surgeon or just have the patient check with them and report back?

 

[callmeanesthesia]

Pretty routine to give a dose of dexamethasone IV during induction. Decreases post-op pain, airway irritation, and PONV. If I recall correctly there’s good anesthesia literature to show it doesn’t raise infection risk.
Still, I agree with giving the surgeon a call and asking - don’t want to get blamed for an infection.