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ORIGINAL ARTICLE
Year : 2014  |  Volume : 27  |  Issue : 4  |  Page : 629-631

The role of intraoperative calcium injection for prevention of postoperative hypocalcaemia after total thyroidectomy


1 Department of Surgery, Shebin El-Kom Teaching Hospital, Shebin El-Kom, Menoufiya, Egypt
2 Department of Surgery, Faculty of Medicine, Menoufiya University, Menoufiya, Egypt
3 Department of Internal Medicine, Faculty of Medicine, Menoufiya University, Menoufiya, Egypt

Correspondence Address:
Amr T Hafez
Department of Surgery, Shebin El-Kom Teaching Hospital, Shebin El-Kom, Menoufiya
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-2098.149626

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Objective The aim of this study was to evaluate the possible role of intraoperative intravenous calcium injection in avoidance of unexplained postoperative hypocalcaemia. Background Thyroid surgery has always been the most common endocrine surgical operation. Total thyroidectomy is generally reserved for patients with thyroid malignancy, toxic thyroid, clinically significant goiter and less commonly for thyroiditis. The complications include recurrent laryngeal nerve injury, external branch of superior laryngeal nerve injury, neck hematoma, and hypocalcaemia. Post-thyroidectomy hypocalcaemia can occur in about 9.5-15.4% of the patients. The prevention of hypocalcaemia is the main concern, as some patients may experience hypocalcaemia despite preservation of the parathyroid glands during surgery. Patients and methods This prospective study on 40 consecutive patients was conducted from March 2011 to January 2013. The patients were randomly divided into two groups: group I (20 patients) received intraoperative intravenous 10 ml of calcium gluconate containing 500 mg of calcium and group II (20 patients) received no injection. Serum calcium level was measured for all patients preoperatively, 6 h and 5 days postoperatively. Results The incidence of postoperative hypocalcaemia was lower in group I than in group II (40 and 65%, respectively); in addition, 35% of the patients in group I suffered from perioral numbness, tingling, and positive Chvostek's sign compared with 50% in group II. In all, 5% of the patients in group I suffered from tetany compared with 15% in group II. Serum calcium levels on the first postoperative day in group I patients were significantly higher than those in group II patients, with mean range of 8.1 ± 0.3 in group I and mean range of 7.8 ± 0.4 in group II. Conclusion The prophylactic intravenous injection of calcium gluconate during total thyroidectomy is effective in minimizing risk for postoperative symptomatic hypocalcaemia.


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