Document Detail


Maternal haemodynamics at elective caesarean section: a randomised comparison of oxytocin 5-unit bolus and placebo infusion with oxytocin 5-unit bolus and 30-unit infusion.
MedLine Citation:
PMID:  20194013     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Rapid intravenous injection of oxytocin is associated with marked hypotension secondary to decreased venous return. Reductions in dose and rate of bolus administration have reduced the incidence of cardiovascular side effects, but no study has yet investigated cardiovascular stability when oxytocin is infused for several hours after delivery. This study compared maternal haemodynamics during a 4-h 30-unit oxytocin infusion and during a placebo infusion following caesarean section.
METHODS: Women booked for elective caesarean section were randomised to receive either oxytocin 5-unit bolus and placebo infusion or oxytocin 5-unit bolus and oxytocin 30-unit infusion. Before, during and for 4 h after surgery electrocardiogram, oxygen saturation, systolic and diastolic pressure and heart rate were monitored non-invasively and cardiac index (CI), left ventricular work index (LVWi) and systemic vascular resistance index (SVRi) by thoracic bioimpedance.
RESULTS: A total of 74 women agreed to haemodynamic measurements. Heart rate, systolic and diastolic pressure, CI, LCWi and SVRi all fell following the onset of spinal anaesthesia, and, with the exception of SVRi, continued to decrease throughout surgery. After delivery of the baby, slow injection of oxytocin 5 units was associated with a temporary rise in CI, LCWi and heart rate, a decrease in SVRi and no change in systolic or diastolic pressure. Thereafter, haemodynamic measures returned to normal over 60 min with no adverse effects apparent from the additional oxytocin infusion.
CONCLUSIONS: An additional oxytocin infusion at elective caesarean section did not adversely affect maternal haemodynamics either during or after surgery.
Authors:
G McLeod; B Munishankar; H MacGregor; D J Murphy
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-03-02
Journal Detail:
Title:  International journal of obstetric anesthesia     Volume:  19     ISSN:  1532-3374     ISO Abbreviation:  Int J Obstet Anesth     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-29     Completed Date:  2010-12-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9200430     Medline TA:  Int J Obstet Anesth     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  155-60     Citation Subset:  IM    
Copyright Information:
Copyright 2009 Elsevier Ltd. All rights reserved.
Affiliation:
Department of Anaesthetics, Ninewells Hospital & Medical School, University of Dundee, Dundee, UK. g.a.mcleod@dundee.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Analysis of Variance
Anesthesia, Spinal / methods*
Area Under Curve
Cardiography, Impedance / methods
Cesarean Section*
Dose-Response Relationship, Drug
Female
Hemodynamics / drug effects*
Humans
Hypotension / chemically induced
Infusions, Intravenous / methods
Oxygen / blood
Oxytocics / administration & dosage*
Oxytocin / administration & dosage*
Surgical Procedures, Elective
Time Factors
Treatment Outcome
Young Adult
Grant Support
ID/Acronym/Agency:
//Chief Scientist Office
Chemical
Reg. No./Substance:
0/Oxytocics; 50-56-6/Oxytocin; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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