Prophylactic steroids may prevent complications of thyroidectomy
A single preoperative dose of dexamethasone reduces rates of postoperative hypocalcemia and voice dysfunction in patients undergoing thyroidectomy, according to a study published online Sept. 2 in JAMA Otolaryngology-Head & Neck Surgery.
Adeel Abbas Dhahri, from the Royal Infirmary Hospital of Edinburgh in the United Kingdom, and colleagues randomly assigned 192 patients who were undergoing thyroidectomy to a single preoperative intravenous dose of either dexamethasone or normal saline (96 patients in each group). Postoperative rates of hypocalcemia and voice dysfunction were the primary outcomes.
The researchers found that in the first 24 hours after thyroidectomy, 24.4 percent of patients developed hypocalcemia and 9.4 percent were symptomatic. At three days postthyroidectomy, hypocalcemia was seen in four of 96 patients in the placebo group and none in the dexamethasone group. At 24 hours postthyroidectomy, 8.3 percent of dexamethasone patients had voice dysfunction versus 33.3 percent in the placebo group.
“This randomized clinical trial demonstrated that a single 8-mg dose of dexamethasone during the preoperative period was safe and effective in improving transient, immediate postoperative hypocalcemia as well as temporary voice dysfunction in patients undergoing thyroidectomy,” the authors write.