Prospective Study of Early Predictive Factors of Hypocalcaemia after Total or Near Total Thyroidectomy in a Tertiary Care Centre

Background: Thyroidectomy though a most common surgical procedure poses two important problemsinjury to the recurrent laryngeal nerve and hypoparathyroidism due to its vital anatomical relations.The advances in anesthetic techniques and knowledge of anatomy enabled us to perform thyroidectomies very safely and thus reduce the complications.But problem of hypoparathyroidism still persists especially in patients undergoing total thyroidectomy for neoplasm.Methods: This study is to determine the early predictive factors of hypocalcaemia in post thyroidectomy patients and to study the usefulness of combined serum calcium and serum parathyroid hormone estimation as early predictors of hypocalcaemia after total or near total thyroidectomy.Results: On serial estimation of serum calcium and serum PTH as an early predictor of hypocalcaemia, it was found that all but few showed an initial drop in serum at 6 hrs and progressive drop observed in patients developed clinical hypocalcaemia or likely to develop hypocalcaemia later and in a subset of patients a likelihood of returning to normal was observed after the initial drop, in those are unlikely to develop the same.Conclusions: Serial estimation of serum calcium if done at regular intervals of 6 & 12 hours, the patients who are likely to develop hypocalcaemia can be predicted early.