Prospective evaluation of a protocol for reduced glucocorticoid replacement in transsphenoidal pituitary adenomectomy: Prophylactic glucocorticoid replacement is seldom necessary

Abstract

Background: Most pituitary surgery centres prescribe perioperative glucocorticoids to subjects undergoing transsphenoidal pituitary adenomectomy (TSA), despite reports suggesting this may be unnecessary. Evidence-based guidelines for glucocorticoid use in TSA have recently been published but there are no prospective studies of their utility. Objective: To implement and assess a protocol for reduced glucocorticoid replacement for subjects undergoing TSA. Design: Prospective and retrospective cohort study in an Australian pituitary surgery centre. Patients and measurements: Clinical and biochemical data for 56 TSAs performed for non-ACTH-secreting tumours between March 2004 and April 2006 were..