Dexamethasone use may prevent hypocalcemia and voice dysfunction post-thyroidectomy: JAMA

The results of the study were found to be

• A total of 192 patients (mean [SD] age, 38.9 years; 156 women [81.2%]) were included in the study, with 96 patients randomized to each study group (dexamethasone group, mean age, 39.2 years; 75 women [78.1%]; placebo group, mean [SD] age, 38.5 [12.9] years; 81 women [84.5%]).

• In the first 24 hours after undergoing thyroidectomy, 47 patients (24.4%) developed hypocalcemia and 18 (9.4%) were symptomatic.

• At 3 days post thyroidectomy, 4 of 96 patients (4.2%) in the placebo group had hypocalcemia compared with no patients in the dexamethasone group.

• At 24 hours post hyroidectomy, 8 of 96 patients (8.3%) in the dexamethasone group had voice dysfunction compared with 32 of 96 patients (33.3%) in the placebo group.

• A total of 40 patients (20.8%) reported voice dysfunction. The absolute reduction in the rate of hypocalcemia at 24 hours was 24% and at 3 days was 4.2%. 

• The rate of symptomatic hypocalcemia was 19% lower in the dexamethasone group than in the placebo group. The rate of voice dysfunction was 25% lower in the dexamethasone group than in the placebo group.

Dhahri, and the team concluded that "In this randomized clinical trial, a single preoperative dose of dexamethasone was safe and effective in reducing postoperative hypocalcemia and voice dysfunction rates in patients undergoing thyroidectomy"

Reference:

Dhahri AA, Ahmad R, Rao A, et al. Use of Prophylactic Steroids to Prevent Hypocalcemia and Voice Dysfunction in Patients Undergoing Thyroidectomy: A Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg. Published online September 02, 2021. doi:10.1001/jamaoto.2021.2190