<prompt> During bilateral adrenalectomy, intraoperative dose of hydrocoisone should be given afterOpening the abdomenLigation of left adrenal veinLigation of right adrenal veinExcision of both adrenal glands  <response>: Patients undergoing surgery for a primary adrenal adenoma secreting glucocoicoids require preoperative and postoperative steroids due to suppression of the contralateral adrenal gland. Duration of steroid therapy is determined by the ACTH stimulation test. Exogenous steroids may be needed for up to 2 years but are needed indefinitely in patients who have undergone bilateral adrenalectomy. This latter group of patients also may require mineralocoicoid replacement therapy. Perioperative and postoperative glucocoicoid administration is obviously essential in the care of patients with Cushings syndrome. For patients undergoing adrenalectomy for Cushings syndrome, perioperative stress dose steroids hydrocoisone, 100 mg IV every 8 hours for 24 hours are recommended. 