Minimum effective bolus dose of oxytocin during elective Caesarean delivery.
نویسندگان
چکیده
BACKGROUND The aim of this study was to determine the lowest effective bolus dose of oxytocin to produce adequate uterine tone (UT) during elective Caesarean delivery (CD). METHODS Seventy-five pregnant patients undergoing elective CD under spinal anaesthesia were randomized to receive oxytocin (0.5, 1, 3, 5 units) or placebo. UT was assessed by a blinded obstetrician as either adequate or inadequate, and using a verbal numerical scale score (0-10; 0, no UT; 10, optimal UT) at 2, 3, 6, and 9 min after oxytocin administration. Minimum effective doses of oxytocin were analysed (ED(50) and ED(95)) using logistic regression. Oxytocin-related side-effects (including hypotension) were recorded. RESULTS There were no significant differences in the prevalence of adequate UT among the study groups at 2 min (73%, 100%, 93%, 100%, and 93% for 0, 0.5, 1, 3, and 5 units oxytocin, respectively). The high prevalence of adequate UT after placebo and low-dose oxytocin precluded determination of the ED(50) and ED(95). UT scores were significantly lower in patients receiving 0 unit oxytocin at 2 and 3 min compared with 3 and 5 units oxytocin (P<0.05, respectively). The prevalence of hypotension was significantly higher after 5 units oxytocin vs 0 unit at 1 min (47% vs 7%; P=0.04). CONCLUSIONS The routine use of 5 units oxytocin during elective CD can no longer be recommended, as adequate UT can occur with lower doses of oxytocin (0.5-3 units).
منابع مشابه
Haemodynamic effects of repeated doses of oxytocin during Caesarean delivery in healthy parturients.
BACKGROUND The haemodynamic effects of oxytocin 5 u have been described previously, but still some authors attribute these effects to the delivery itself. We studied the haemodynamic effects of two repeated doses of oxytocin i.v. in 20 healthy women during spinal anaesthesia for Caesarean delivery. METHODS Data were obtained from a randomized controlled study of 80 pregnant women undergoing a...
متن کاملStudy Protocol. ECSSIT – Elective Caesarean Section Syntocinon® Infusion Trial. A multi-centre randomised controlled trial of oxytocin (Syntocinon®) 5 IU bolus and placebo infusion versus oxytocin 5 IU bolus and 40 IU infusion for the control of blood loss at elective caesarean section
BACKGROUND Caesarean section is one of the most commonly performed major operations in women throughout the world. Rates are escalating, with studies from the United States of America, the United Kingdom, China and the Republic of Ireland reporting rates between 20% and 25%. Operative morbidity includes haemorrhage, anaemia, blood transfusion and in severe cases, maternal death. The value of ro...
متن کاملOxytocin requirements at elective cesarean delivery: a dose-finding study.
OBJECTIVE Oxytocin is frequently used by intravenous bolus and infusion to minimize blood loss and prevent postpartum hemorrhage at cesarean delivery. Current dosing regimens are arbitrary whereas large doses may pose a serious risk to the mother. The purpose of this study was to estimate the minimum effective intravenous bolus dose of oxytocin (ED90) required for adequate uterine contraction a...
متن کاملHaemodynamic Effects of Oxytocin as Intravenous Bolus or Infusion on Women Undergoing Caesarean Section
Oxytocin is commonly used in obstetric practice as uterotonic drug for induction and augmentation of labour (1) and remains the drug of choice for facilitating uterine contractions during vaginal and operative delivery (2). Several regimens of oxytocin have been tested during cesarean delivery (CD) with variable wanted (uterotonic) and unwanted (cardiovascular) effects (3-7). When given as a ra...
متن کاملOxytocin bolus versus oxytocin bolus and infusion for control of blood loss at elective caesarean section: double blind, placebo controlled, randomised trial
OBJECTIVES To determine the effects of adding an oxytocin infusion to bolus oxytocin on blood loss at elective caesarean section. DESIGN Double blind, placebo controlled, randomised trial, conducted from February 2008 to June 2010. SETTING Five maternity hospitals in the Republic of Ireland. PARTICIPANTS 2069 women booked for elective caesarean section at term with a singleton pregnancy. ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- British journal of anaesthesia
دوره 104 6 شماره
صفحات -
تاریخ انتشار 2010