Q:

What is postoperative hypocalcemia?

waelhammad
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2022-11-19
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A young female of 24 years, presents with bony pains and difficulty in walking for 2 years. Her plain radiographs show fractures of right shaft of tibia and fibula and diffuse osteopenia. Screw and plating was seen at right femur for which patient gives a past history of fracture due to trivial trauma 3 years back. Her biochemical parameters reveal serum Ca 13.4 mg/dL, serum phosphorus 1.4 mg/dL, serum creatinine 1.2 mg/dL. Hb is 11.0 g%. 25(OH)D value is 45 ng/dL and her PTH is 108 pg/mL. USG abdomen shows left renal calculus. BMD shows severe osteoporosis. Her past history reveals being treated for 6 months for pulmonary tuber- culosis 4 years back. Her mother expired from non-Hodgkin’s lymphoma 12 years back.

What is postoperative hypocalcemia?

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waelhammad
2022-11-19
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Decline in serum Ca occurs within 24 hours of successful surgery; lasts for 3–5 days Once hypocalcemia occurs, it signifies successful surgery – Give High Ca intake, Oral Ca supplements If serum calcium persistently <8 mg/dL + Phosphate level rises → consider that surgery has caused hypoparathyroidism With unexpected hypocalcemia → consider coexistent hypomagnesemia Parenteral Ca when hypocalcemia is symptomatic : IV Ca 1–2 mg/kg/hour If asymptomatic → No treatment required

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