Abstract
Normally the body responds to stress by increasing secretion of Cortisol. When the adrenal cortex is diseased or when the pituitary does not secrete enough adrenocorticotropic hormone to stimulate Cortisol production, Cortisol levels are inadequate to maintain homeostasis and even minor stress can lead to shock. For help in withstanding the stress of surgery, patients with known or suspected adrenal insufficiency need special preventive management.