Comparison of two infusion doses of oxytocin in parturients undergoing elective caesarean section

Dr. Mamta Bhardwaj; Dr Shashi Kiran; Dr Kiranpreet Kaur; Dr Raj Kumar

Volume : VI, Issue : XII, December - 2017

Comparison of two infusion doses of oxytocin in parturients undergoing elective caesarean section

Dr. Mamta Bhardwaj, Dr Shashi Kiran, Dr Kiranpreet Kaur, Dr Raj Kumar

Abstract :

Introduction

Oxytocin is routinely administered as an intravenous (IV) bolus followed by infusion for adequate uterine contraction.¹ We aimed to compare two different infusion doses of oxytocin (3 IU vs 2 IU over 5 min) followed by maintenance infusion in terms of hemodynamic effects, uterine contraction and adverse effects.

Material & Methods

Fifty patients in age group of 20–35 years, undergoing elective caesarean section under spinal anaesthesia (SA) were enrolled. The patients were randomly allocated to receive 3 International units (IU) of oxytocin (Group I) or 2 IU of oxytocin (group II) as an infusion over 5 minutes. HR and MAP were measured at 2 minute interval up to 10 minutes after SA, at time of delivery and at 2 minute interval up to 10 minutes after oxytocin administration and 5 min interval up to 30 min.. After 3 minutes, obstetricians were asked about adequacy of uterine contraction and noted as either �adequate� or �inadequate. If uterus was not adequately contracted after 5 minutes, oxytocin 2.5 IU IV was given as rescue dose. A maximum of 2 rescue doses were given. If still the uterus was not contracted, misoprostol 800 mcg suppository was given.

Results

Two patients developed hypotension after SA and required ephedrine before delivery. Changes in HR and MBP were not significant between the groups. Group II (2 U over 5 min) patients needed more number of rescue doses of oxytocin than group I, while only one patient in each group needed rescue uterotonic other than oxytocin.

Conclusion

Infusion of 3 IU over 5 minutes is better than 2 IU as less rescue bolus of oxytocin is required with its use.