During bilateral adrenalectomy, intraoperative dose of hydrocoisone should be given after –
**Core Concept**
During bilateral adrenalectomy, the adrenal glands are removed, leading to the loss of cortisol production. Hydrocortisone is administered to replace this lost cortisol and prevent adrenal insufficiency. The timing of hydrocortisone administration is crucial to prevent a sudden drop in cortisol levels.
**Why the Correct Answer is Right**
The correct answer is related to the timing of hydrocortisone administration after adrenal gland removal. Cortisol has a half-life of approximately 8 hours, and it takes time for the administered hydrocortisone to reach peak levels and replace the lost cortisol. Administering hydrocortisone after the adrenal glands are removed allows enough time for the cortisol levels to drop, making it easier to assess the need for replacement therapy. This is in accordance with the protocol of administering hydrocortisone 8-12 hours after bilateral adrenalectomy.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not take into account the half-life of cortisol and the time required for hydrocortisone to reach peak levels.
**Option B:** This option is incorrect because it does not follow the established protocol for hydrocortisone administration after bilateral adrenalectomy.
**Option C:** This option is incorrect because it does not consider the physiological effects of cortisol replacement therapy and the timing of its administration.
**Clinical Pearl / High-Yield Fact**
It is essential to remember that the timing of hydrocortisone administration after bilateral adrenalectomy is critical to prevent adrenal insufficiency. A delay in hydrocortisone administration can lead to a sudden drop in cortisol levels, which can be life-threatening.
**Correct Answer: C.**