Most patients following parathyroidectomy will only need paracetamol and ibuprofen as pain relief.  Some might require 1-3 days of codeine or Tramadol.
 
Following unilateral parathyroidectomy, I normally prescribe 1 calcium tablet daily as prophylaxis.  The PTH level is checked few hours following surgery and the calcium level is checked next day.  Most patients are discharged the next day. Post-operatively calcium levels drop for two reasons.  Firstly, it’s because parathyroid gland that has been removed is the one that is normally producing majority of PTH.  The other glands are suppressed, it may take them several days to restart producing PTH.  Secondly, even in patients who did not have thyroid or parathyroid surgery, calcium levels drop day 2 or day 3 due to postoperative hormonal changes involved in diuresis (water excretion).   The calcium level in the blood will be monitored weekly and calcium stopped usually within 1-3 weeks. 
 
Following bilateral parathyroidectomy, I normally prescribe 2 calcium tablet daily as prophylaxis.  The PTH level is checked few hours following surgery and the calcium level is checked next day.  Most patients are discharged the next day, some may stay for 2 days following operation, but this is rare. Few people may also require addition of Vitamin D to keep the calcium levels normal (usually these people have low post-operative Parathyroid hormone, PTH, levels).  Post-operatively calcium levels drop for three reasons. 

Firstly, it’s because parathyroid gland that has been removed is the one that is normally producing majority of PTH.  The other glands are suppressed, it may take them several days to restart producing PTH.  Secondly, it’s because parathyroid glands may be injured or disturbed.  Thirdly, during the surgery even in patients who did not have thyroid or parathyroid surgery, calcium levels drop day 2 or day 3 due to postoperative hormonal changes involved in diuresis (water excretion).   The calcium levels will be monitored weekly until the calcium and vitamin D supplementation (if prescribed) is stopped, usually within 3-8 weeks.