Influence of magnesium sulphate infusion before total thyroidectomy on transient hypocalcemia – a randomised study
Background. Transient hypocalcemia is the most common complication after thyroidectomy. Normomagnesemia is needed for normal secretion of PTH and end-organ responsiveness. Our aim was to determine the influence of infusion of magnesium sulphate before thyroidectomy on the incidence of laboratory and clinical transient hypocalcemia.
Methods. In our prospective study, 48 patients (5 men, 43 women; age 22-73 years, median 45 years), who underwent total or near-total thyroidectomy, were randomised preoperatively. Half of them received intravenously 4 ml of 1M magnesium sulphate at the beginning of the surgical procedure, the other half were the control group. Serum concentrations of calcium, ionised calcium, magnesium, phosphate, albumin and PTH were measured prior to surgery and on the first day after surgery.
Results. Laboratory postoperative hypocalcemia was present in 27% of patients and 23% of patients had clinical signs and/or symptoms of postoperative hypocalcemia. The concentration of total calcium (p=0.024) and of albumin (p=0.01) was lower in the group that received magnesium sulphate.
Conclusions. The patients who received infusion of magnesium sulphate before total thyroidectomy had lower concentration of total serum calcium and albumin in comparison to the control group. There was no statistical difference in the incidence of clinical transient hypocalcemia.