How does the normal adrenal gland respond to surgery?
In a baseline state, the adrenal gland secretes the equivalent of 20 to 30 mg of cortisol (e.g., hydrocortisone; equivalent to 5–7.5 mg prednisone) per day, but with major stress or general anesthesia, it may increase 10-fold up to 200 to 300 mg of cortisol (50–75 mg of prednisone) per day. Cortisol levels typically peak within 24 hours of the time of surgical incision and return to normal after 72 hours if no other factors contribute to perioperative stress.
