Evaluation of serum calcium level in total thyroidectomy patients

Background: Thyroidectomy remains to be one of the most common surgeries done and has been associated with few specific complications. One major complication of thyroidectomy is hypocalcemia, which often occurs as a result of inadvertent intra-operative injury to parathyroid glands. Transient hypocalcaemia, which is usually noticed after surgery, resolves well most of the times as it respond to replacement therapy in few days. Aim of the study: To study the incidence of transient hypocalcemia occurring in patients undergoing total thyroidectomy Materials and methods: The methods for the study included screening of patients who presented with thyroid swelling alone or along with pain, hoarseness of voice and dysphagia symptoms. Such patients were studied in detail clinically and investigated as per proforma detailed below. Hematologic and biochemical investigations were done. All patients were subjected to ultrasonographic evaluation and thyroid function tests initially. Following which they had undergone a fine needle aspiration biopsy for histological diagnosis. Patients who were suspected to have malignancy were made to undergo other imaging modalities as CT. Results: 28% of cases developed hypocalcaemia by 6 hours while 24% of cases had hypocalcemia after 72 hours. Post-operatively only 5 patients had developed symptoms of hypoparathyroidism. These were found to have reduced calcium levels at both 6hrs and 72 hours of surgery and hypocalcemia had resolved in 5 patients by 72 hours who had drop in 6 hours post-operatively. Conclusion: The maximum incidence of clinically symptomatic hypocalcemia was found in the age group of more than 35 to 65 and those cases had reduced serum calcium levels measured at both 6 hours and 72 hours.