Preventive Effect of Dexamethasone Therapy on the Transient Hypoparathyroidism through Total Thyroidectomy

This study aimed to investigate whether pre-operative dexamethasone could ameliorate transient hypoparathyroidism outcome through total thyroidectomy.

This randomized clinical trial study was conducted on 128 patients underwent total thyroidectomy from March 2014 to April 2015. Patients were randomly assigned to two groups of experimental receiving 8 mg IV of intravenous dexamethasone (n=45) 45 min before skin incision treatment and control (n=83). After the surgery, all patients were evaluated for clinical and laboratory hypocalcaemia.

Post-operative transient biochemical hypoparathyroidism and hypocalcaemia did not occur more often in the control group, compared to the dexamethasone group while controlling for the baseline variables. However, there was a significant difference in phosphorus level between the dexamethasone and control groups (P=0.028). A total of 50 (39.1%) patients developed hypocalcaemia after surgery. Moreover, post-operative symptomatic hypocalcemia occurred more frequently in the control group (68%) compared to the dexamethasone group (32%); however, this difference was not statistically significant (P=0.54).

The pre-operative administration of dexamethasone reduced post-operative hypocalcemia rate. It is essential to conduct future studies with validated means for better results.