Frequency of Electrocardiographic Changes Indicating Myocardial Ischemia During Elective Cesarean Delivery With Regional and General Anesthesia: Detection Based On Continuous Holter Monitoring and Serum Markers of Ischemia

Doğan, Rafi; Birdane, Alparslan; Bilir, Ayten; Ekemen, Serdar; Tanriverdi, Belkıs

doi:10.1097/01.aoa.0000350620.60227.3d

Cited by 2 publications

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“…Svanstrom et al 5 included 20 patients in each group which means that an event that does not occur frequently could easily have been missed. By contrast, Dogan et al, 27 in a study of 20 patients (epidural and spinal anaesthesia), found that ST-depressions were unrelated to oxytocin administration and hypotension. Nevertheless, the only episode of ST-depression that occurred in the group with spinal anaesthesia in that study also displayed an episode of hypotension.…”

Section: Discussionmentioning

confidence: 85%

ST depression at caesarean section and the relation to oxytocin dose. A randomised controlled trial

Jonsson

Hanson

Lidell

et al. 2009

BJOG

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Objective To investigate whether there is a difference in occurrence of electrocardiogram changes suggestive of myocardial ischaemia between two different doses of oxytocin.Design Double-blind randomised controlled trial Setting University hospital in Sweden.Population A total of 103 healthy women undergoing elective caesarean section under spinal anaesthesia.Methods The participants were randomised to 5 or 10 units of oxytocin, given as an intravenous bolus. A Holter monitor was used to record electrocardiograms and non invasive blood pressure and heart rate (HR) was monitored. A blood sample was obtained 12-hour postoperatively.Main outcome measures Depression of the ST segment. Secondary outcomes: symptoms, Troponon I levels, mean arterial pressure (MAP), HR and blood loss.Results There was a significant difference in occurrence of ST depressions associated with oxytocin administration, 4 (7.7%) with 5 and 11 (21.6%) with 10 units, P < 0.05. The absolute risk reduction was 13.9% (95% confidence interval, 0.5-27.3). Decrease of mean MAP from baseline to 2 minutes differed, being 9 mmHg in the 5 unit group and 17 mmHg in the 10 unit group (P < 0.01). The increase in mean HR did not differ. Troponin I levels were increased in four subjects (3.9%). There were no differences in occurrence of symptoms, Troponin I levels, or estimated blood loss.Conclusion ST depressions were associated with oxytocin administration significantly more often in subjects receiving 10 units compared with 5 units. Interventions to prevent hypotension during caesarean section may reduce the occurrence of ST depressions on electrocardiograms.

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Section: Discussionmentioning

confidence: 85%

ST depression at caesarean section and the relation to oxytocin dose. A randomised controlled trial

Jonsson

Hanson

Lidell

et al. 2009

BJOG

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“…Les évènements coronariens rapportés au cours de la grossesse sont rares (environ 1/10 000) [11][12][13][14][15] et sont en augmentation compte tenu du vieillissement de la population des parturientes. Les dérivés ocytociques sont classiquement connus pour avoir des effets indésirables cardio-vasculaires.…”

Section: Commentaireunclassified

“…Les dérivés ocytociques sont classiquement connus pour avoir des effets indésirables cardio-vasculaires. [11][12][13][14][15] Des observations de tachycardie, d'hypotension artérielle accompagnée de bouffées vasomotrices voire de douleurs thoraciques sont régulièrement rapportées dans la littérature, en particulier dans 37% à 55% des cas dans les études de l'équipe de Toronto. [8][9][10] Cependant, la description exacte des symptômes de ces quelques cas de douleurs thoraciques était peu détaillée.…”

Section: Commentaireunclassified

Syndrome coronarien aigu après injection de carbétocine 100 µg au cours d’une césarienne en urgence

Jacquenod¹,

Cattenoz²,

Canu³

et al. 2015

Can J Anesth/J Can Anesth

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Frequency of Electrocardiographic Changes Indicating Myocardial Ischemia During Elective Cesarean Delivery With Regional and General Anesthesia: Detection Based On Continuous Holter Monitoring and Serum Markers of Ischemia

Cited by 2 publications

References 0 publications

ST depression at caesarean section and the relation to oxytocin dose. A randomised controlled trial

ST depression at caesarean section and the relation to oxytocin dose. A randomised controlled trial

Syndrome coronarien aigu après injection de carbétocine 100 µg au cours d’une césarienne en urgence

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