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Indian Journal of Clinical Anaesthesia


Comparison of three different regimes of oxytocin in patients undergoing elective caesarean section – to estimate the haemodynamic changes and uterine contraction


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Author Details: Shetty Guruprasad, Bhat Manjunath Timmappa, Torgal SV

Volume : 4

Issue : 1

Online ISSN : 2394-4994

Print ISSN : 2394-4781

Article First Page : 74

Article End Page : 79


Abstract

Background: In spite of repeated use of oxytocin, the minimum effective dose oxytocin is not clear. Oxytocin when administered in excess dose may cause unwanted cardiovascular effects like tachycardia and hypotension and when the dose is inadequate it can result in uterine atony and increased uterine bleeding. We compared three different regimes of oxytocin in patients undergoing elective caesarean delivery, to compare haemodynamic changes and uterine contraction.
Methods: Ninety patients undergoing elective caesarean delivery were administered an i.v bolus of either 3U or 5U and without bolus of oxytocin after delivery, followed by an oxytocin infusion of 20 U/h. Spinal anaesthesia was administered to all patients and with MAP more than 60 mmHg received respective oxytocin doses. We compared changes in MAP, heart rate, uterine tone, blood loss, the need for additional uterotonic and antiemetic drugs.
Results: In our study maximum hypotension was in 5U oxytocin bolus with infusion group i.e. twenty three patients (76%) when compared with three patients (10%) in 3U bolus with infusion group and five patients (16%) in only infusion group. The pulse rate was increased to a greater extent in 5U bolus group than 3U and without bolus groups. Uterine tone was very good in patients who received 5U, good in 3U and inadequate to adequate in without bolus. Eleven patients (37%) in 20U infusion group were required additional uterotonic drugs when compared to two patients (7%) in 5U and 3U with infusion groups. The antiemetics used were highest after 5U (63%) than 3U (10%) and without bolus (3%).
Conclusion: Lower dose of oxytocin bolus is better than higher bolus dose and without bolus dose based on the oxytocin effect on haemodynamic changes and uterine contraction.