Steroids In Perioperative period...The Multi-purpose Drugs

1-Steroids are not Bronchodilator ,but have well established usefulness in hyper-reactive airway.

They are also said to have a permissive role for bronchodilator medication.

They can be administered orally, parenterally or in aerosol form

2- Steroids have been commonly used in chemotherapy for prevention of nausea along with other anti-emetic agents.

Dexamethasone was found to be highly effective when given immediately before induction rather than at the end of anesthesia.

3-Steroids do exert analgesic effects. Various routes of administration of steroids include parentral, local infiltration at operated site, as an adjuvant in nerve blocks and central-neuraxial blockade.

4-Steroids cannot be the mainstay of therapy in anaphylaxis because of the delayed onset of action, so they are used as adjunct after initial treatment with epinephrine.

5-Steroids (Dexamethsone) are of value in reduction or prevention of cerebral edema associated with parasitic infections and neoplasms.

6-The use of steroids remains controversial for cord injuries because improvement is minimal and difficult to document.
Steroids must be used within 8 hrs of cord insult to be of any benefit.

7-corticosteroids decreased the risk of postextubation stridor in children by about 40%. However, the effect of corticosteroids in children and adults to reduce postextubation complications such as reintubation is uncertain