Hypocalcaemia from parathyroid injury is the commonest complication of total thyroidectomy, and symptoms can appear within the first day or two. Perioral tingling and finger paraesthesia are early signs; carpopedal spasm and, rarely, seizures or arrhythmia follow if it is missed.
A postoperative calcium or parathyroid hormone level guides who needs supplements and who can go home safely.
- Measure calcium, and parathyroid hormone where available, after total or completion thyroidectomy
- Ask about perioral and fingertip tingling at each ward review
- Give patients written warning symptoms and a route back if they occur after discharge
- Arrange follow-up of calcium for anyone discharged on supplements
Why it matters
Hypocalcaemia after thyroidectomy is common, predictable and easy to miss after early discharge.
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