Comparison of the benefits and hemodynamic side effects of oxytocin between intravenous infusion with and without bolus injection during caesarean section

Miyoshi, Yasuhiro; Kaneko, Shohei; Suga, Shin Ichi; Koga, Megumi; Sugimi, So; Yamashita, Hiroshi; Yamaguchi, Masahide; Yasuhi, Ichiro

doi:10.1080/01443615.2020.1780421

Cited by 5 publications

(6 citation statements)

References 15 publications

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“…All of these have emphasised the benefits of using minimum effective doses, as intravenous infusion or bolus, but always as non-weight-based, pre-defined, fixed amounts. 1,[5][6][7][8][9][10][11][12] The optimum dose for oxytocin infusions in non-weight based dose was previously reported to be 17.4 IU h À1 , when the average weight of included patients was 85 kg. 1 The present result for a weight-based ED90 being 0.29 IU kg À1 h À1 yields a calculated nonweight based dose of 17.6 IU h À1 for our cohort (= 0.29 X the noted average weight of 60.9 kg).…”

Section: Resultsmentioning

confidence: 99%

“…There are several studies evaluating optimum dose of intraoperative oxytocin during caesarean delivery. All of these have emphasised the benefits of using minimum effective doses, as intravenous infusion or bolus, but always as non‐weight‐based, pre‐defined, fixed amounts 1,5–12 …”

Section: Discussionmentioning

confidence: 99%

“…1,[5][6][7][8] Infusions, rather than boluses of oxytocin have also been successfully evaluated to prevent intraoperative uterine atony and avoiding haemodynamic side effects. [8][9][10][11][12] The minimum effective dose (ED90) of oxytocin infusion to achieve adequate uterine tone during caesarean delivery in non-labouring parturients was shown to be 0.29 IU min À1 (95% CI 0.15 to 0.43) and 0.26 IU min À1 (95% CI 0.22 to 0.32) in two separate studies. 1,8 We hypothesised that using oxytocin infusion as per the patients actual weight may also have a clinically acceptable role.…”

Section: Introductionmentioning

confidence: 97%

“…It is advocated to use oxytocin in lower doses than conventionally used for minimising the associated side effects 1,5–8 . Infusions, rather than boluses of oxytocin have also been successfully evaluated to prevent intraoperative uterine atony and avoiding haemodynamic side effects 8–12 . The minimum effective dose (ED90) of oxytocin infusion to achieve adequate uterine tone during caesarean delivery in non‐labouring parturients was shown to be 0.29 IU min −1 (95% CI 0.15 to 0.43) and 0.26 IU min −1 (95% CI 0.22 to 0.32) in two separate studies 1,8 …”

Section: Introductionmentioning

confidence: 99%

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Weight‐based oxytocin infusion for preventing uterine atony during caesarean delivery in non‐labouring patients: A dose–response study

Tyagi

Salhotra

et al. 2023

Clin Exp Pharma Physio

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Postpartum haemorrhage remains a significant cause of maternal morbidity and mortality with the commonest reason being uterine atony. For prevention of uterine atony during caesarean delivery, oxytocin is advocated as a first line drug. There is however no published data regarding utility of a weight-based oxytocin infusion. The present study evaluated dose-response relationship for oxytocin infusion when used as weight-based regimen. A total of 55 non-labouring patients without risk factors for uterine atony and scheduled for caesarean delivery under spinal anaesthesia were enrolled. Randomization was done to receive oxytocin infusion in a dose of 0.1, 0.15, 0.2, 0.25 or 0.3 IU kg À1 h À1 (n = 11 each), initiated at the time of cord clamping and continued until the end of surgery.Successful outcome was defined as attaining an adequate uterine response at 4 min of initiation of infusion and maintained till end of surgery. Oxytocin associated hypotension, tachycardia, ST-T changes, nausea/vomiting, flushing and chest pain were also observed. A significant linear trend for adequate intraoperative uterine tone was seen with increasing dose of weight-based oxytocin infusion (P < 0.001). The effective dose in 90% population (ED90) was 0.29 IU kg À1 h À1 (95% CI = 0.25-0.42). Amongst the oxytocin associated side effects, a significant linear trend was seen between increasing dose of oxytocin infusion and hypotension as well as nausea/vomiting (p = 0.016 and 0.023 respectively). Thus, oxytocin infusion during caesarean delivery may be used as per the patient's body weight.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Weight‐based oxytocin infusion for preventing uterine atony during caesarean delivery in non‐labouring patients: A dose–response study

Tyagi

Salhotra

et al. 2023

Clin Exp Pharma Physio

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“…Previous studies had reported that baseline SBP (Fakherpour, Ghaem et al, 2018;Shitemaw, Jemal et al, 2020) and MAP (Bishop, Cairns et al, 2017), block-surgery time (Shitemaw, Jemal et al, 2020), sensory block height (Hartmann, Junger et al, 2002;Fakherpour, Ghaem et al, 2018;Shitemaw, Jemal et al, 2020) and oxytocin utilization (Rumboll, Dyer et al, 2015;Miyoshi, Kaneko et al, 2020) were linked with neuraxial anaesthesia-related hypotension. Nevertheless, present data failed to nd the statistically signi cant differences in COVID-19 parturients regarding these factors.…”

Section: Discussionmentioning

confidence: 97%

Incidence and Associated Factors for Neuraxial Anaesthesia-Related Hypotension in COVID-19 Parturients Undergoing Caesarean Delivery: A Multicenter Case-Control Study

Zhang

Chen

Cao

et al. 2021

Preprint

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Background: COVID-19 continues to spread globally and results in additional challenges for perioperative management in parturients. The purpose of this study was to determine the incidence and identify associated factors for neuraxial anaesthesia-related hypotension in COVDI-19 parturients during caesarean delivery.Methods: We performed a multicenter case-control study at 3 medical institutions in Hubei province, China form 1th January to 30th May 2020. All ASA Physical Status II full termed pregnant women who received caesarean delivery under neuraxial anaesthesia were eligible for inclusion. The univariate analysis and binary logistic regression analysis were used to identified the independent predictors of neuraxial anaesthesia-related hypotension.Results: Present study included 102 COVID-19 parturients. The incidence of neuraxial anaesthesia-related hypotension was 58%. Maternal abnormal lymphocyte count (OR = 3.41, p = 0.03), full stomach (OR = 3.22, p = 0.04), baseline heart rate (OR = 1.04, p = 0.03), experience of anaesthetist (OR = 0.86, p = 0.02) and surgeon (OR = 0.76, p = 0.03), and combined spinal-epidural anaesthesia technique (OR = 3.27, p = 0.02) were associated with neuraxial anaesthesia-related hypotension. The area under the receiver operating characteristic curve achieved 0.83 which was significantly higher than 0.5 (p < 0.001). And the sensitivity, specificity and percentage correct were 75%, 79% and 75%, respectively. The Hosmer-Lemeshow test showed a good calibration of the model (H = 2.01, DF = 8, p = 0.98).Conclusions: Maternal abnormal lymphocyte count, full stomach, baseline heart rate, experience of anaesthetist and surgeon, and combined spinal-epidural anaesthesia technique were identified as the independent predictors of neuraxial anaesthesia-related hypotension.

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Treatment of hypotension during neuraxial anesthesia for cesarean section: clinical guidelines

Kulikov

Вениаминович²,

Shifman

et al. 2021

Regional Anesthesia and Acute Pain Management

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Comparison of the benefits and hemodynamic side effects of oxytocin between intravenous infusion with and without bolus injection during caesarean section

Cited by 5 publications

References 15 publications

Weight‐based oxytocin infusion for preventing uterine atony during caesarean delivery in non‐labouring patients: A dose–response study

Weight‐based oxytocin infusion for preventing uterine atony during caesarean delivery in non‐labouring patients: A dose–response study

Incidence and Associated Factors for Neuraxial Anaesthesia-Related Hypotension in COVID-19 Parturients Undergoing Caesarean Delivery: A Multicenter Case-Control Study

Treatment of hypotension during neuraxial anesthesia for cesarean section: clinical guidelines

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