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Major procedures . caesarian section, joint replacement or other operations requiring a general anaesthetic always require parental steroids. As a rule, patients should take their usual doses the day before surgery, and on the morning of surgery for later procedures. 100mg intra-muscular hydrocortisone should then be administered on induction of the anaesthetic, and the dose repeated 6 hourly thereafter for 24-48 hours or until the patient is able to eat and drink normally. Patients should then typically take double their usual dose for 48hours, or until they are feeling back to normal, at which they should resume their usual dose.