Had steroid injection 12 days before surgery. Will this be a problem?

Question

I had a dexamethasone inj (steroid shot) for tonsillitis and I have 12 days before surgery. I plan to tell the anesthesiologist tomorrow because I want to be safe. I read online that the half like is 12 hours for IM injection but I’m nervous they will cancel or postpone me. I’m having a tummy tuck, muscle repair and lipo. What do you think?

Christopher Pannucci, MD, MS · Answer

Hi Inventive2045,
Steroids decrease inflammation which is great for tonsillitis but bad for wound healing.
For elective surgeries, I suggest patients have no steroids for at least a month...and for those who have recently taken steroids, I typically suggest high volume vitamin A supplementation, which can counteract some of the negative wound healing repercussions of steroids.
I would definitely discuss with your surgeon (not just your anesthesiologist) in advance--not in the preop area, preferably!
Hope this helps!
Best,Christopher Pannucci MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question. It's great that you’re being proactive about your health and planning to inform your anesthesiologist about the steroid injection. Here’s what you should know about its potential impact on your upcoming tummy tuck, muscle repair, and liposuction surgery.

Dexamethasone is a corticosteroid commonly used to reduce inflammation. While it has a half-life of about 12 hours, its effects on the immune system and tissue healing can last longer, depending on the dosage and frequency of use. Steroids can potentially impair wound healing, increase the risk of infection, and affect the body’s ability to respond to stress, which is a concern during surgery.

It’s crucial to tell your anesthesiologist and surgeon about the injection. They’ll assess how the steroid may impact your surgical plan and post-operative healing. In many cases, a single injection 12 days before surgery poses minimal risk, but adjustments may be necessary:

If your body has been exposed to steroids recently, your surgical team might administer a small dose of steroids during surgery to ensure your body can handle the stress. Post-operative care might include closer monitoring to ensure optimal healing.
The likelihood of cancellation is low if the steroid injection was a one-time treatment and not part of a longer regimen. However, the final decision will depend on your surgical team’s assessment of your overall health and readiness for surgery.

Be upfront about the injection and the reasons for it when meeting with your anesthesiologist and surgeon. Ensure you’re following all pre-operative guidelines, including maintaining good nutrition and avoiding smoking or other activities that can impair healing. If your surgeon recommends postponing the surgery to allow the effects of the steroid to wear off completely, it’s in your best interest to follow that guidance.
Steroid injections are commonly administered, and your surgical team is well-versed in managing this situation. With clear communication and planning, it’s unlikely to become a significant issue.

Sincerely,
Dr. Katzen

Daniel Barrett, MD · Answer

Dear Inventive2045,
every plastic surgeon has his own preoperative protocol which he recommends to his patients. I would suggest you to discuss this with your plastic surgeon.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

You will need to discuss this with your surgeon who will inform you if surgery can proceed as scheduled.  It is always important to let your surgeon know of any medication- prescription or over the counter- that you take as well as any supplements.  Your safety is the number one priority in surgery.

Karthik Ram, MRCS, DNB · Answer

Good that you are paying attention to such details about your health. 
Ongoing medications do have significance in the pre surgery assessment by anaesthesialogist. So you have to tell them all recent medications and illnesses. In your case single steroid injection 12 days prior to surgery may not have significant impact on the plan of surgery. 
But the concerning element is the level of recovery of your tonsillitis. The swelling in the throat if persistent can be troublesome to give you general anaesthesia, and if the infection hasn't subsided then it poses an infection risk for the cosmetic surgery you are undergoing. Please discuss these points with your treating physician and the anaesthesiologist. Wishing a safe surgery for you.

Michael Ablavsky, MD · Answer

I'm glad you asked this question. I think it is very important that you DO NOT keep anything from your surgeon or your anesthesiologist. Intramuscular steroid injection depending on the dose, your body habitus etc. can have systemic effects. High dose systemic steroids may impact your ability to heal wounds, or can affect the metabolism of various medications. You should have a discussion with your surgeon and anesthesiologist about the steroid shots - they can plan accordingly to get you a safe and optimal surgical outcome.

Had steroid injection 12 days before surgery. Will this be a problem?

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