What is considered the #1 complication after thyroidectomy within the first 8 to 12 hours?

The most significant complication following a thyroidectomy in the first 8 to 12 hours is hemorrhage. This is primarily due to the vascular nature of the thyroid gland, which is rich in blood supply. During and after surgery, there is a risk of bleeding from the surgical site, which could lead to a hematoma.

If not addressed promptly, hemorrhage can lead to airway obstruction and significant hemodynamic instability, making it crucial for healthcare providers to monitor patients closely during this period. Signs of hemorrhage may include swelling at the surgical site, difficulty breathing, stridor, or a drop in blood pressure.

While other complications such as pneumonia, infection, or hypocalcemia can also occur after a thyroidectomy, they typically manifest later in the recovery process or post-operatively. Hypocalcemia, for instance, is often related to damage to the parathyroid glands and usually occurs a bit later as calcium levels drop following surgery. Thus, hemorrhage is prioritized as the most immediate and critical complication to watch for in the early hours following the procedure.