I met the chief of surgery at my new site today. Nice enough guy, seemed like an excellent surgeon. However, right after induction my MDA whispered to me, "no steriods."

I shrugged and held off the 4mg of dex I had ready to go. At the end of the 3rd case, the surgeon started talking to me while the resident worked. He told me that he never wanted any of his patients to be given dexamethsone. He told me that there were no studies showing that dex did not increase infection rates and sepsis. "John, that's a lot of steriod. It's just a trend, it will come and go. So, don't ever give it to one of my patients."

Confession: I give just about everyone who gets GA dex and zofran. I may hold the dex in diabetics. At the least the dex helps control the sore throat from student instrumentation of the airway

What do you guys think? Is there any know downside of 4mg of dex, do any studies exist showing any adverse to this dose? Any reason I should change my practice?