COMPARISON OF EFFICACY AND SAFETY OF TWO DIFFERENT BOLUS DOSES OF OXYTOCIN DURING ELECTIVE CAESAREAN DELIVERY: A PROSPECTIVE RANDOMISED CONTROLLED STUDY

Dr A V Varsha; Dr M D Gopalakrishna; Dr Shyamsunder Kamath

Volume : VI, Issue : IX, September - 2016

COMPARISON OF EFFICACY AND SAFETY OF TWO DIFFERENT BOLUS DOSES OF OXYTOCIN DURING ELECTIVE CAESAREAN DELIVERY: A PROSPECTIVE RANDOMISED CONTROLLED STUDY

Dr A V Varsha, Dr M D Gopalakrishna, Dr Shyamsunder Kamath

Abstract :

OBJECTIVE: To determine the optimal dose of oxytocin during elective caesarean delivery (CD) for adequate uterine tone with least haemodynamic adverse effects. METHODOLOGY: 90 women undergoing CD under spinal anaesthesia were randomised to receive either oxytocin bolus (group O2–2 units, group O5–5 units) or saline followed by oxytocin infusion (5 units/ hour). Primary outcome was adequacy of uterine tone 2 minutes after initial bolus. Secondary outcomes included haemodynamic adverse events, requirement for rescue uterotonics, emesis and blood loss. RESULTS: Significant differences were noted in distribution of “clinically acceptable” uterine tone at 2 minutes (56.7%, 86.7% and 93.3% for placebo, O–2 and O–5 respectively, p 0.001). The differences remained significant at 3 (p 0.01) and 5 minutes (0.004). Number of patients with hypotension at 1 minute was more in O–5 (36.7%) compared to placebo (6.7%) and O–2 (20%) (p 0.017). Need for additional uterotonic agents was higher in placebo (63%) compared to O–2 (30%) and O–5 (20%) (p 0.01). Emesis and postoperative Haemoglobin fall were maximum in placebo (p 0.043 and 0.014 respectively). Both the oxytocin groups were comparable in efficacy. Adverse effects were more with O–5. CONCLUSION: 2 units oxytocin bolus followed by infusion has a favorable efficacy and safety profile in elective CD.