EFFECTS OF THREE DOSES OF OXYTOCIN (3, 5 AND 10 IU) ON HAEMODYNAMIC PARAMETERS, UTERINE TONE AND BLOOD LOSS IN ELECTIVE CAESAREAN SECTION UNDER SPINAL ANAESTHESIAA PROSPECTIVE, RANDOMISED, DOUBLE-BLIND STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 35
Abstract
BACKGROUND Obstetric haemorrhage due to uterine atony has been the major complication during elective caesarean section. Oxytocin either bolus and/ or infusion has been the drug of choice to reduce the incidence of peripartum haemorrhage because of less side-effects compared to other uterotonic drugs like methylergometrine. On literature search, we found that different doses of oxytocin ranging from 0.3 to 20 IU have been used by various researchers. Low doses were associated with inadequate uterotonic effect, whereas higher doses were found to be associated with serious haemodynamic side effects. Hence, we decided to find out minimal dose of oxytocin required to produce adequate uterine tone and stable haemodynamic parameters in women undergoing elective caesarean section. The aim of this study is to compare the effects of three doses of oxytocin (3, 5 and 10 IU) on haemodynamic parameters, uterine tone and blood loss in elective caesarean section under spinal anaesthesia. MATERIALS AND METHODS This randomised, double-blind study was conducted in one hundred and fifty full-term pregnant women undergoing elective caesarean section under spinal anaesthesia. All patients received intravenous infusion of either 3 (O3), 5 (O5) or 10 (O10) IU of oxytocin after foeto-placental delivery. Uterine Tone (UT) was assessed by obstetrician who was not aware of the drug doses as either adequate or inadequate using a five-point scale, where 1= atonic, 2= partial and inadequate, 3= adequate contraction, 4= well contracted and 5= very well contracted at 2, 4, 6 and 10 mins after oxytocin infusion. Oxytocin related side-effects (including hypotension) were recorded. Minimum effective doses of oxytocin were analysed according to effect on various circulatory parameters, uterine tone and blood loss during surgery. RESULTS Uterine Tone (UT) was significant in Groups O3, O5 and O10 (p= 0.00). Lower dose of oxytocin (O3 > O5 > O10) was associated with less uterine tone and more blood loss (p < 0.05). The fall in SBP, DBP and MAP was statistically significant in Group O10 (O10>O5>O3). Any other side effects if occurred were recorded. CONCLUSION Administration of 5 IU oxytocin as intravenous infusion in elective caesarean section resulted in adequate uterine tone, stable haemodynamic parameters, lesser blood loss and self-limiting side-effects as compared to 3 and 10 IU.
Authors and Affiliations
Dilip Kothari, Seema Bhalavi, Anju Gautam, Bhanu Choudhary, Sandeep Dahiya, Varun Pathak
Keywords
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- EP ID EP544876
- DOI 10.14260/jemds/2018/875
- Views 68
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