What is a significant risk of performing surgery on a patient who is adrenally suppressed?

When a patient is adrenally suppressed, their body has a diminished ability to produce corticosteroids, which are vital for managing stress and maintaining hemodynamic stability. Surgery is a significant stressor that can trigger the need for increased cortisol production to help the body respond appropriately. If the patient cannot produce enough cortisol due to adrenal suppression, there is a risk of a drop in blood pressure, potentially leading to shock. This occurs because corticosteroids play a crucial role in the regulation of vascular tone and fluid balance.

The body's inadequacy to cope with stress can lead to inadequate perfusion of vital organs, which exacerbates the risks associated with surgery. Therefore, the significant concern with adrenal suppression during surgical procedures is indeed the potential drop in blood pressure and the risk of shock. This highlights the importance of monitoring and possibly supplementing corticosteroids in patients with known adrenal insufficiency undergoing surgery to mitigate these risks.