Frequency of Post-Operative Hypocalcemia after Total Thyroidectomy for Graves’  Disease versus Multinodular Goiter

Objective: To compare the frequency of post-operative hypocalcemia after total thyroidectomy for Graves’ disease compared with multinodular goiter. Study Design: Quasi experimental study. Place and Duration of Study: Department of Surgery, Pak-Emirates Military Hospital, Rawalpindi Pakistan, from Mar 2022 to Feb 2023. Methodology: A total of 161 patients were enrolled and divided into two groups, where Group-A consisted of 110 patients, undergoing total thyroidectomy for multinodular goiter, while Group-B had 51 patients, undergoing total thyroidectomy for Graves’ disease. Participants were enrolled using non-probability sequential sampling. All data was collected on a self-designed data collection tool and manually entered into data analysis software for final analysis. Results: Our study found hypocalcemia after 24 hours of total thyroidectomy in 11(10.0%) patients of Group-A and 9(17.6%) patients of Group-B, with an additional 21(19.1%) patients from Group-A and 13(25.4%) patients of Group-B when 48 hours had elapsed (p-value=0.06). Serum calcium levels performed two months after surgery detected low levels in 4(3.6%) patients of multinodular goiter and in 7(13.7%) patients with Graves’ disease (p=0.034). Conclusion: Patients with Graves’ disease have greater likelihood than patients of multinodular goiter, of experiencing transient hypocalcemia and persistent hypocalcemia after total thyroidectomy, warranting more careful monitoring in these patients.