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Effect of general anesthesia and intubation on parathyroid levels in normal patients and those with hyperparathyroidism
Author(s) -
Cinamon Udi,
Gavish Doron,
Ovnat Tamir Sharon,
Goldfarb Abraham,
Ezri Tiberiu
Publication year - 2018
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.25002
Subject(s) - medicine , primary hyperparathyroidism , intubation , parathyroidectomy , endotracheal intubation , anesthesia , general anaesthesia , parathyroid hormone , surgery , calcium
Background Induction of general anesthesia and endotracheal intubation may precipitate parathyroid hormone (PTH) elevation in patients with primary hyperparathyroidism (HPT). The purposes of this study were to revisit this observation and to study its impact in healthy patients. Methods Patients with primary HPT who underwent parathyroidectomy were retrospectively studied. The PTH was sampled and compared: before, immediately after general anesthesia and endotracheal intubation, and 15 minutes after parathyroidectomy. Healthy adults who underwent elective operations were prospectively studied. The PTH was sampled before general anesthesia and endotracheal intubation, immediately after, and 15 minutes later. Results Thirty‐one patients, aged 28‐89 years (mean 60.1 ± 13 years), were retrospectively studied. The PTH was significantly elevated after general anesthesia and endotracheal intubation ( P = .014). Fifty patients, aged 21‐86 years (mean 54 ± 15 years), were prospectively studied. The PTH elevation after general anesthesia and endotracheal intubation was not significant. Conclusion General anesthesia and endotracheal intubation causes an immediate, steep, and significant PTH elevation in patients with primary HPT but only a minor change in healthy adults. The difference may be attributed to an impaired adrenergic response in patients with primary HPT.