{"id":"f27b9d02-49a7-4254-ba08-0bbe78a5c2bf","slug":"before-blaming-glucocorticoids-for-prolonged-postoperative-hypotension-alternative-explanations-must-be-carefully-ruled-out","title":"Before blaming glucocorticoids for prolonged postoperative hypotension, alternative explanations must be carefully ruled out","authors":["Josef Finsterer"],"abstract":"Background: The article discusses a case of persistent arterial hypotension in a 9-year-old girl during surgery, attributed to glucocorticoid-induced suppression of the hypothalamic-pituitary-adrenal (HPA) axis. The authors highlight that resistant hypotension can occur after both chronic and single high doses of steroids, with various risk factors identified. Summary: The letter raises important considerations regarding the potential causes of intraoperative hypotension beyond glucocorticoid effects. It suggests that left ventricular systolic dysfunction, the mass lesion itself, anesthetic drug effects, and pituitary hormone levels should be evaluated. The authors emphasize the need for further investigation into these factors to clarify the etiology of the hypotension. Conclusion: The authors argue that before attributing persistent intraoperative hypotension to glucocorticoids and HPA suppression, alternative explanations must be thoroughly investigated. Addressing these limitations could enhance the understanding and interpretation of the case. Keywords: hypotension, glucocorticoids, HPA axis, Takotsubo syndrome, anesthesia, pituitary hormones, mass lesion, systolic dysfunction","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/placeholders/specialty/neuroanesthesia-and-critical-care.png","publishDate":"2024-09-27T00:00:00.000Z","doi":"10.25259/SNI_691_2024","categories":["Neuroanesthesia and Critical Care","Letter to the Editor"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/f27b9d02-49a7-4254-ba08-0bbe78a5c2bf/pdf"}