FREQUENCY OF POST-OPERATIVE HYPOCALCAEMIA WITH OR WITHOUT PRE-OPERATIVE CALCIUM SUPPLEMENTATION AFTER TOTAL THYROIDECTOMY IN HYPERTHYROIDISM
INTRODUCTION: Hypocalcemia after thyroid surgery is an significant and serious complication with estimates ranging from 0.5% to 75%. While symptomatic hypocalcemia is self-limiting in most cases, it is of special concern owing to a delay in its presentation and the concomitant need for extended hospital stays or re-admission.
OBJECTIVE: To determine the frequency of postoperative hypocalcaemia with and without pre-operative calcium supplementation after total thyroidectomy in hyperthyroidism
MATERIAL & METHODS: A RCT was conducted in West Surgical Ward, Mayo Hospital, Lahore from June 7, 2017 to December 7, 2017. Total 176 patients were included in study. They were randomly allocated into two groups using lottery method. Group-A (treatment group) received Tab calcium carbonate 1gm per orally 8 hourly for two weeks prior to surgery. Group-B (control group) did not receive Tab calcium carbonate before surgery. All the patients underwent total thyroidectomy preserving parathyroid glands performed by same team of surgeons. Symptoms and signs of Hypocalcemia were noted. Using SPSS v24.0 data were entered and analysed. Chi-square test was used to compare proportions between both groups. Age and gender were matched to address the effect modifiers. A p-value ≤0.05 was labelled as significant.
RESULTS: Total 176 patients were enrolled in the research. Patients were broken down into two study groups i.e. Group-A (Treatment) and Group-B (Controls). Group-A included 18(20.5%) males and 70(79.5%) females, while Group-B had 12(13.6%) males and 88(86.4%) females. In group-A, mean age was 45.0±15.4 years and 44.9±15.9 years in group-B. In group-A, 26(29.5%) had hypocalcemia, while 44(50.0%) suffered in group-B, which is statistically significant (p-value=0.006).
CONCLUSION: Incidence and severity of hypocalcemia following total thyroidectomy in hyperthyroidism can be reduced effectively by preoperative oral calcium supplementation given routinely.