DOI: https://doi.org/10.36347/sjams.2025.v13i09.007

Pages: 1668-1673

Background: Total thyroidectomy is a common surgical procedure for treating thyroid malignancies and benign disorders like multinodular goiter and Graves' disease. Despite its benefits, it carries a significant risk of postoperative hypoparathyroidism due to parathyroid gland damage or accidental removal, leading to hypocalcemia. Monitoring intact parathyroid hormone (iPTH) levels postoperatively is crucial for predicting hypocalcemia, yet data on this relationship, particularly in Bangladesh, remain limited. Objective: This study aimed to evaluate the postoperative status of intact parathyroid hormone after total thyroidectomy. Methodology: A prospective observational study was conducted at Dhaka Medical College Hospital, involving 90 total thyroidectomy patients. Preoperative serum iPTH and calcium levels were measured, followed by iPTH assessment 20 minutes post-surgery and calcium levels 48–72 hours postoperatively. Patients with iPTH <15 pg/mL or calcium <8.5 mg/dL received oral calcium and vitamin D. Socio-demographic, clinical, and postoperative data were analyzed. Results: Among 90 patients (mean age 37.7±9.4 years), 37.6% developed hypoparathyroidism (iPTH <15 pg/mL) postoperatively, and 26.7% exhibited hypocalcemia (<8.5 mg/dL). The 36–45 age group showed the highest incidence of both complications (44.4% and 36%, p<0.01). Paresthesia (50%) was the most frequent hypocalcemia symptom. Serum calcium significantly declined from 8.87±0.31 mg/dL preoperatively to 8.07±0.54 mg/dL postoperatively (p<0.001). All hypocalcemic cases had reduced iPTH (p<0.001), underscoring its predictive value. Conclusion: Post-thyroidectomy hypoparathyroidism and hypocalcemia remain significant complications, particularly in patients aged 36-45 years. Early iPTH monitoring effectively identifies high-risk patients, enabling timely intervention. These findings support routine iPTH assessment to guide calcium supplementation and improve postoperative management in thyroidectomy patie