ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Thyroid Endocrinology
This article is part of the Research TopicState of the Art Parathyroid Identification and Preservation in Thyroid and Parathyroid SurgeryView all articles
Effect of Topical Papaverine on Parathyroid Function Preservation After Total Thyroidectomy: A Retrospective Cohort Study
Provisionally accepted
- 1International college, Zhengzhou University, Zhengzhou, China
- 2The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- 3Lanzhou University, Lanzhou, China
- 4Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
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Objective: To evaluate the effectiveness of locally applied papaverine in preventing hypoparathyroidism after total thyroidectomy and its impact on parathyroid hormone (PTH) recovery. Study Design: Retrospective cohort study. Setting: The First Affiliated Hospital of Zhengzhou University. Methods: This single-center retrospective cohort study involved 226 patients who underwent total thyroidectomy at the First Affiliated Hospital of Zhengzhou University from March 2023 to March 2025. The incidence of hypoparathyroidism on postoperative day 1 and the PTH recovery rate within 30 days afterward are compared between patients who received papaverine and those who did not. Data analysis uses the independent samples t-test, the Mann-Whitney U test, and the χ² test. Results: Patients are divided into two groups: those who received intraoperative papaverine (n = 106) and a control group (n = 120). On postoperative day 1, hypoparathyroidism occurs in 40% of the papaverine group and 53% of the control group, respectively. Postoperative PTH recovery rates gradually increase over time, with significantly higher rates in the papaverine group compared to the control group on days 3, 5, and 30. Conclusion: Applying papaverine directly during surgery effectively lowers the risk of early hypoparathyroidism after total thyroidectomy while promoting faster PTH recovery. This method is simple, easy to perform, and has a high safety profile. Future multicenter randomized controlled trials should be conducted to confirm long-term effectiveness and refine the dosing protocol.
Keywords: Papaverine, Total thyroidectomy, Parathyroid function, Microcirculation, Thyroid Gland
Received: 29 Jul 2025; Accepted: 03 Nov 2025.
Copyright: © 2025 LI, Li, Hou, Yinqin, Shi, Ying, Duan and Zheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Shouhua Zheng, zshtgzyyx@163.com
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