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A Prophylactic Infusion of Calcium Solution Reduces the Risk of Symptomatic Hypocalcemia in Patients after Total Thyroidectomy

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Abstract

Background

Several risk factors have been associated with post-operative transient hypocalcemia after thyroid surgery. However, there are no studies evaluating preventive measures to avoid symptomatic postoperative hypocalcemia. Although intravenous infusion of calcium improves hypocalcemic symptoms, it is unknown whether prophylactic infusion prevents symptoms of postoperative hypocalcemia.

Patients and Methods

Five hundred and forty-seven patients underwent total thyroidectomy. Two groups were identified: group A (n = 243) received prophylactic intravenous drip infusion of 78–156 mg of calcium solution at 3–8hours after operation, and group B (n = 304) received no prophylactic treatment. Prophylactic infusion was used only once if the patients did not have symptoms of hypocalcemia. Serum calcium (Ca) levels, intact parathyroid hormone (i-PTH) levels on the first postoperative day (1st POD), and the prevalence of symptoms of hypocalcemia were prospectively analyzed.

Results

The serum Ca levels at the 1st POD in group A patients (7.91 ± 0.49 mg/dl, mean ± SD) was significantly higher than group B patients (7.65 ± 0.54, P < 0.0001), while the serum i-PTH levels were not significantly different between the two groups. The prevalence of numbness and / or tetany before noon on the 1st POD was significantly lower in group A patients. Prophylactic infusion of calcium solution reduced the prevalence of tetany from 8.6% to 2.1%.

Conclusion

A prophylactic infusion of calcium solution after total thyroidectomy may be useful in reducing the development of symptomatic hypocalcemia and reduces the patients’ risk of having discomfort and anxiety due to hypocalcemia.

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Acknowledgement

The author is grateful to Dr Electron Kebebew, Department of Surgery, University of California San Francisco/Mt Zion Medical Center, for his valuable suggestions regarding the manuscript.

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Authors and Affiliations

  1. Department of Surgery, Kuma Hospital, 8-2-35 Shimoyamate-dori Chuo-ku, Kobe, 650-0011, Japan

    Takashi Uruno, Akira Miyauchi, Chisato Tomoda, Yuuki Takamura, Yasuhiro Ito, Akihiro Miya, Kaoru Kobayashi, Fumio Matsuzuka & Kanji Kuma

  2. Division of Endocrine Surgery, Department of Surgery II, Nippon Medical School, 1-1-5 Sendagi Bunkyo-ku, Tokyo, 113-8603, Japan

    Kazuo Shimizu

  3. Department of Internal Medicine, Kuma Hospital, 8-2-35 Shimoyamate-dori Chuo-ku, Kobe, 650-0011, Japan

    Nobuyuki Amino

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  1. Takashi Uruno
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  2. Akira Miyauchi
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  3. Kazuo Shimizu
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  4. Chisato Tomoda
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  5. Yuuki Takamura
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  6. Yasuhiro Ito
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  7. Akihiro Miya
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  11. Kanji Kuma
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Correspondence to Takashi Uruno.

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Uruno, T., Miyauchi, A., Shimizu, K. et al. A Prophylactic Infusion of Calcium Solution Reduces the Risk of Symptomatic Hypocalcemia in Patients after Total Thyroidectomy. World J. Surg. 30, 304–308 (2006). https://doi.org/10.1007/s00268-005-0374-5

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  • DOI: https://doi.org/10.1007/s00268-005-0374-5

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