SAN FRANCISCO-Hypocalcemia prophylaxis can halve hospital stays for parathyroid exploration and thyroidectomies.
After routine calcium and magnesium prophylaxis, begun at Brigham and Women’s in 1993, the mean stay there was 1.35 days for 43 patients who had elective parathyroid surgery and 48 who had total or near-total thyroidectomy. Those with serum calcium over 8.1 mg/dL were allowed to leave on postop day one.
In contrast, the mean stay before routine prophylaxis for 29 patients’ elective parathyroid surgery was 1.97 days, says endocrine surgeon Francis D. Moore Jr. For 39 total or near-total thyroidectomy patients, it was 2.15 days.
When 23-hour observation, calcitrol prophylaxis, and a switch from narcotics to bupivacaine were added in 1995, length of stay fell to 1.12 days for 51 parathyroid patients and 1.11 days for 53 thyroid patients, Dr. Moore told the American College of Surgeons meeting here.
