Diagnostic value of intraoperative parathyroid hormone decline in prediction of hypocalcemia after total thyroidectomy

Transient or definitive hypocalcemia is one of the most important complications following total thyroidectomy. Monitoring of serum calcium levels or calcium replacement in all patients are methods commonly used to avoid this problem. Our objective was to validate the intraoperative parathormone assay (PTH) as a predictive tool in these situations. We conducted a prospective study of 46 patients undergoing total thyroidectomy. PTH levels were obtained during the anesthetic induction, 10min after the procedure and 24h after surgery. Calcium levels were obtained 24 and 48h after surgery. The predictive value of postoperatory levels of PTH and its decline respect the preoperatory levels for prediction of hypocalcemia was measured. Hypocalcemia was defined as an ionized calcium