Background: Oxytocin is generally used in obstetric exercise as a uterotonic drug for induction and augmentation of labor and stays the drug of desire for facilitating uterine contractions through vaginal and operative delivery. It is now spreading up to far-flung areas. The infusion method of oxytocin is protected in the cesarean area under spinal anesthesia. Objective: This study evaluates the hemodynamic modifications precipitated by oxytocin given as an I/V bolus or infusion to limit uterine bleeding in cesarean section. Methods: This prospective interventional study was carried out at the Department of Anesthesiology, 250 Bed General Hospital, Noakhali, Bangladesh, from January to December 2020. A total of 50 patients with ASA grade I have been selected, with 25 affected people in every group. In group A, the parturients were given oxytocin 5 IU I/V bolus; in group B, an infusion of oxytocin 5 IU diluted with 5 ml everyday saline given I/V over 2 min using an infusion pump. The learning about duration started out simply earlier than oxytocin is given, and it used to be persisted for an additional 10 min. Systolic and diastolic BP, MAP, coronary heart rate, and uterine bleeding have been recorded every 1 min. Results: In our study, every group had n=25. All outcomes are expressed as mean ± standard deviation. The studied groups were statistically matched for age, gestational age, weight, coronary heart rate, systolic and diastolic blood pressure, and arterial pressure. The implied distinction of all hemodynamic parameters at 2 to 5 minutes of oxytocin administration has been statistically significant (p < 0.05). Conclusion: Oxytocin remains the first-line uterotonic drug after vaginal and cesarean delivery. The hemodynamic changes were more marked in the I/V bolus of oxytocin than infusion technique. Recent research elucidates the therapeutic range of oxytocin during cesarean delivery and receptor desensitization. A slower injection of oxytocin can effectively minimize cardiovascular side effects and equally effectively reduce blood loss without compromising the therapeutic benefits. Evidence-based protocols for preventing and treating uterine atony during cesarean delivery are recommended.
Jackson GM, Sharp HT. Cervical ripening before induction of labour: a randomized trial of prostaglandin E2 gel versus low dose oxytocin. Am J Obstet Gynecol. 1994 Oct;171(4):1092-6. https://doi.org/10.1016/0002-9378(94)90042-6
Cunnigham FG, Mac Donald PC, Gant Nf. Casearean section and caesarean hysterectomy in Williams obstetrics Norwalk. Appleton and Lange. 1989; 441-59.
Gori F, Pasqualucci A, Corradetti F, Milli M, Peduto VA. Maternal and neonatal outcome after cesarean section: the impact of anesthesia. J Matern Fetal Neonatal Med. 2007 Jan;20(1):53-7. https://doi.org/10.1080/14767050601134645
Liu S, Liston RM, Joseph KS, Heaman M, Sauve R, Kramer MS, et al. Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term. CMAJ. 2007 Feb 13;176(4):455-60. https://doi.org/10.1503/cmaj.060870
Ronsmans C, Graham WJ; Lancet Maternal Survival Series steering group. Maternal mortality: who, when, where, and why. Lancet. 2006; 368(9542):1189-200. https://doi.org/10.1016/s0140-6736(06)69380-x
Auroy Y, Narchi P, Messiah A, Litt L, Rouvier B, Samii K. Serious complication related to regional anaesthesia result in a prospective survey in France. Anesthesiology. 1997 Sep;87(3):479-86. https://doi.org/10.1097/00000542-199709000-00005
Dutt DC, Pharmacotherapeutics in obstetrics, Text book of obstetric and gerontology and contraception, 6th edition Calcutta; New central book agency (P) Ltd. 2004; 33:498.
Clark SL, Simpson KR, Knox GE, Garite TJ. Oxytocin: new perspectives on an old drug. Am J Obstet Gynecol. 2009 Jan;200(1):35.e1-6. https://doi.org/10.1016/j.ajog.2008.06.010
Ratnam SS. Bashket K RAO, Arulkumaran S. induction of labour, obstetrics and gynaecology, orient Longman Ltd. 1994; 16(2): 198.
Garfield RE, Beir S. Increased myometrial responsiveness to oxytocin during term and preterm labor. Am J Ot Gyn. 1989 Aug;161(2):454-61.https://doi.org/10.1016/0002-9378(89)90541-3
British National Formulary. 78th ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain; 2019. Joint Formulary Committee. Obstetrics, Gynaecology, and Urinary-tract Disorders; 823–4.
Thomas JS, Koh SH, Cooper GM. Haemodynamic effects of oxytocin given as i.v. bolus or infusion on women undergoing Caesarean section. Br J Anaesth. 2007 Jan;98(1):116-9. https://doi.org/10.1093/bja/ael302
Dansereau J, Joshi AK, Helewa ME, Doran TA, Lange IR, Luther ER, et al. Double-blind comparison of carbetocin versus oxytocin in prevention of uterine atony after cesarean section. Am J Obstet Gynecol. 1999 Mar;180(3 Pt 1):670-6. https://doi.org/10.1016/s0002-9378(99)70271-1
Rosaeg OP, Licutti NJ, Labow RS. The effects of oxytocin on the contractile force of human atrial trabeculae. Anesth Analg. 1998 Jan;86(1):40-4. https://doi.org/10.1097/00000539-199801000-00008
Langesaeter E, Rosseland LA, Stubhaug A. Haemodynamic effects of repeated doses of oxytocin during Caesarean delivery in healthy parturients. Br J Anaesth. 2009 Aug;103(2):260-2. https://doi.org/10.1093/bja/aep137
Pinder AJ, Dresner M, Calow C, O’Riordan J, Johnson R. Haemodynamic changes caused by oxytocin during caesarean section under spinal anaesthesia. Int J Obstet Anesth. 2002 Jul;11(3):156-9. https://doi.org/10.1054/ijoa.2002.0970
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2021 Mainuddin Ahmed, Monowar Hossain , Khondaker Shaheen Hossain, Md Belal Uddin, Faruk Ahmed