Parathyroid Hormone Fluctuations During Thyroid and Parathyroid Surgery
Abstract Objective Stress hormone levels such as cortisol and epinephrine increase with general anesthesia (GA) and surgery. Parathyroid hormone (PTH) has been shown to increase with GA in those undergoing parathyroidectomy (PT) with abnormal parathyroid function, but there are conflicting reports o...
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Wiley
2025-01-01
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| Online Access: | https://doi.org/10.1002/oto2.70068 |
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| author | Emily S. Sagalow Yuna Kim Shirley Wong Robert C. Wang |
| author_facet | Emily S. Sagalow Yuna Kim Shirley Wong Robert C. Wang |
| author_sort | Emily S. Sagalow |
| collection | DOAJ |
| description | Abstract Objective Stress hormone levels such as cortisol and epinephrine increase with general anesthesia (GA) and surgery. Parathyroid hormone (PTH) has been shown to increase with GA in those undergoing parathyroidectomy (PT) with abnormal parathyroid function, but there are conflicting reports of it in those with normal parathyroid function. In this study, we aim to determine the effects of anesthetic and surgical stress on those with abnormal parathyroid function undergoing PTs as well as those with normal parathyroid function undergoing unilateral/total thyroidectomies (UTs/TTs). Study Design Prospective study. Setting Single tertiary academic center. Methods Patients undergoing TT, UT, and PT were studied. PTH was measured consecutively during the preoperative, postanesthetic induction before incision, intraoperative, and postoperative periods. Results One hundred sixty patients were included, with 77 and 31 undergoing TT and UT, respectively, and 52 undergoing PT. Mean PTH levels were significantly higher following induction and intubation across all groups (TT: 139.2 vs 65.1 pg/mL, 113.8% increase; UT: 130.4 vs 57.1 pg/mL, 128.4% increase; PT: 219.6 vs 163.7 pg/mL, 34.1% increase) and remained elevated until excision (TT: 131.8 pg/mL; UT: 124.9 pg/mL; PT: 228.7 pg/mL). Following UT, mean PTH declined to preoperative levels by 1 hour postexcision. Compared to thyroidectomy groups, PTH in the PT group showed more variable responses to anesthesia induction. Conclusion PTH consistently increases in response to anesthetic and surgical stress in adults undergoing UT and TT with normal preoperative parathyroid function. In contrast, those with hyperparathyroidism demonstrated variable changes. |
| format | Article |
| id | doaj-art-fb64548b81184da598cb0e4e46d92fe0 |
| institution | DOAJ |
| issn | 2473-974X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | OTO Open |
| spelling | doaj-art-fb64548b81184da598cb0e4e46d92fe02025-08-20T02:48:41ZengWileyOTO Open2473-974X2025-01-0191n/an/a10.1002/oto2.70068Parathyroid Hormone Fluctuations During Thyroid and Parathyroid SurgeryEmily S. Sagalow0Yuna Kim1Shirley Wong2Robert C. Wang3Department of Otolaryngology–Head and Neck Surgery University of Nevada Las Vegas School of Medicine Las Vegas Nevada USADepartment of Otolaryngology–Head and Neck Surgery University of Nevada Las Vegas School of Medicine Las Vegas Nevada USADepartment of Otolaryngology–Head and Neck Surgery University of Nevada Las Vegas School of Medicine Las Vegas Nevada USADepartment of Otolaryngology–Head and Neck Surgery University of Nevada Las Vegas School of Medicine Las Vegas Nevada USAAbstract Objective Stress hormone levels such as cortisol and epinephrine increase with general anesthesia (GA) and surgery. Parathyroid hormone (PTH) has been shown to increase with GA in those undergoing parathyroidectomy (PT) with abnormal parathyroid function, but there are conflicting reports of it in those with normal parathyroid function. In this study, we aim to determine the effects of anesthetic and surgical stress on those with abnormal parathyroid function undergoing PTs as well as those with normal parathyroid function undergoing unilateral/total thyroidectomies (UTs/TTs). Study Design Prospective study. Setting Single tertiary academic center. Methods Patients undergoing TT, UT, and PT were studied. PTH was measured consecutively during the preoperative, postanesthetic induction before incision, intraoperative, and postoperative periods. Results One hundred sixty patients were included, with 77 and 31 undergoing TT and UT, respectively, and 52 undergoing PT. Mean PTH levels were significantly higher following induction and intubation across all groups (TT: 139.2 vs 65.1 pg/mL, 113.8% increase; UT: 130.4 vs 57.1 pg/mL, 128.4% increase; PT: 219.6 vs 163.7 pg/mL, 34.1% increase) and remained elevated until excision (TT: 131.8 pg/mL; UT: 124.9 pg/mL; PT: 228.7 pg/mL). Following UT, mean PTH declined to preoperative levels by 1 hour postexcision. Compared to thyroidectomy groups, PTH in the PT group showed more variable responses to anesthesia induction. Conclusion PTH consistently increases in response to anesthetic and surgical stress in adults undergoing UT and TT with normal preoperative parathyroid function. In contrast, those with hyperparathyroidism demonstrated variable changes.https://doi.org/10.1002/oto2.70068parathyroid hormoneparathyroidectomyperioperativestress hormonethyroidectomy |
| spellingShingle | Emily S. Sagalow Yuna Kim Shirley Wong Robert C. Wang Parathyroid Hormone Fluctuations During Thyroid and Parathyroid Surgery OTO Open parathyroid hormone parathyroidectomy perioperative stress hormone thyroidectomy |
| title | Parathyroid Hormone Fluctuations During Thyroid and Parathyroid Surgery |
| title_full | Parathyroid Hormone Fluctuations During Thyroid and Parathyroid Surgery |
| title_fullStr | Parathyroid Hormone Fluctuations During Thyroid and Parathyroid Surgery |
| title_full_unstemmed | Parathyroid Hormone Fluctuations During Thyroid and Parathyroid Surgery |
| title_short | Parathyroid Hormone Fluctuations During Thyroid and Parathyroid Surgery |
| title_sort | parathyroid hormone fluctuations during thyroid and parathyroid surgery |
| topic | parathyroid hormone parathyroidectomy perioperative stress hormone thyroidectomy |
| url | https://doi.org/10.1002/oto2.70068 |
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