Endocrine Abstracts

Introduction: One of the notable morbidity after total thyroidectomy is hypocalcemia related symptoms. Various treatments ranging from oral to parenteral calcium have been advocated. In this context, we analysed the benefits of bolus calcium vis-à-vis infusions for symptomatic post-thyroidectomy hypocalcemia.

Patient and methods: The study was conducted in Endocrine Surgery Department in a teritiary care hospital. All the patients with benign thyroid disease, who underwent total thyroidectomy and suffered from symptomatic hypocalcemia were included. The data was prospectively analyzed seperately for Group A treated with intermittent bolus calcium and Group B treated with decrementally graduated calcium infusion. All the patients were supplemented with equal doses of oral calcium and vitamin D.

Results: The study period was 12 months (October 2011–September 2012). Group A and B included 32 and 30 cases respectively. 7/30 in Group B and 1/32 in Group A suffered from thrombophlebitis. Treatment costed mean of INR 232 in Group A and INR 665 for Group B. Both thrombophlebitis and cost factors were statistically significant. Symptomatic hypocalcemia lasted for a mean of 2.3 days in Group A vs 2.5 days in Group B, which was statistically insignificant. None of the patients in both groups suffered from permanent hypoparathyroidism.

Conclusions: Intermittent bolus calcium treatment appears to be less expensive, simpler and less morbid approach compared to continuous infusion for treating post-thyroidectomy hypocalcemia.

Keywords: Hypocalcemia; Thyroidectomy; Thrombophlebitis, vitamin D, hypoparathyroidism.