Hemodynamic Effects of Oxytocin when Given as Bolus or Slow Intravenous Infusion During Cesarean Section

N. Begum, Tahamina Khanum, R. Khatun, Nelufa Tahera Rahman
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Abstract

Background: Oxytocin is a uterotonic drug with profound haemodynamic effects. The effects of oxytocin on women undergoing cesarean section include tachycardia, hypotension and decreased cardiac output. These can be sufficient to cause significant compromise in high risk patients. Objective: This study aims to find out a simple way to decrease these risks without compromising the therapeutic benefits such as decreasing bleeding after delivery and uterine contraction. Materials and Methods: We recruited 60 women undergoing cesarean section. The subjects were randomly divided into two groups, 30 subjects per group, randomly selected by blind envelope method. Group A: parturient received 5 IU bolus (approximately over 2 seconds). Group B: parturient received 5 IU oxytocin IV slow infusion (diluted with 10 mL distilled water) over 2 minutes. Results: A significant increase in heart rate and fall in blood pressure in the group where oxytocin was given IV bolus compared to the slow IV infusion group. There were no differences in the estimated blood loss and uterine contraction between the two groups. Conclusion: The haemodynamic changes are more marked in the IV bolus than the slow IV infusion of oxytocin. Slower injection of oxytocin can effectively minimize the cardiovascular side effects without compromising the therapeutic benefits. J Enam Med Col 2021; 11(2): 92-98
剖宫产时应用催产素丸或缓慢静脉滴注对血液动力学的影响
背景:催产素是一种具有深远血液动力学作用的子宫内药物。催产素对剖宫产妇女的影响包括心动过速、低血压和心输出量下降。这些可能足以在高危患者中造成显著的损害。目的:本研究旨在找到一种简单的方法来降低这些风险,同时又不影响治疗效果,如减少产后出血和子宫收缩。材料和方法:我们招募了60名剖宫产妇女。受试者随机分为两组,每组30名,采用盲信封法随机抽取。A组:产妇接受5IU的推注(大约超过2秒)。B组:产妇接受5IU催产素静脉缓慢输注(用10mL蒸馏水稀释)2分钟。结果:与缓慢静脉滴注组相比,静脉滴注催产素组的心率显著增加,血压显著下降。两组之间估计的失血量和子宫收缩量没有差异。结论:与缓慢静脉滴注催产素相比,静脉推注的血液动力学变化更为显著。放慢催产素的注射速度可以在不影响治疗效果的情况下有效地将心血管副作用降至最低。搪瓷医学杂志2021;11(2):92-98
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35 weeks
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