Postoperative relative adrenal insufficiency in elderly

Corticosteroid hormones play a significant role in the control of vascular smooth muscle tone by their permissive effects in potentiating vasoactive responses to vasoconstrictors. Inadequate cortisol response in stress conditions such as the perioperative period, despite normal serum cortisol concentrations is defined as relative adrenal insufficiency. We report a patient who underwent vaginal hysterectomy and developed hypotension postoperatively. There was no improvement on fluid administration and vasopressor infusion. The patient clinically improved with administration of hydrocortisone.