Volume : 7, Issue : 5, May - 2018

MINIMUM EFFECTIVE BOLUS OF OXYTOCIN IN ELECTIVE CAESAREAN SECTION

Dr Krishna Kumar Tripathi, Dr. Madhurima Singh

Abstract :

<p class="MsoNormal"><b style="mso-bidi-font-weight:normal"><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-fareast-font-family:&quot;Times New Roman&quot;;color:windowtext">Objectives</span></b><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-fareast-font-family:&quot;Times New Roman&quot;;color:windowtext">To estimate the minimum effective bolus dose of oxytocin required to produce adequate uterine tone at 2min for patients undergoing elective caesarean delivery with spinal anesthesia.</span><span style="font-size:12.0pt;line-height:115%;font-family:&#10;&quot;Times New Roman&quot;,&quot;serif&quot;;color:windowtext"><o:p></o:p></span></p> <p class="Normal1" style="margin-top:12.0pt;text-align:justify"><b style="mso-bidi-font-weight:normal"><span style="font-size:12.0pt;line-height:&#10;115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&quot;Times New Roman&quot;;&#10;color:windowtext">Methodology</span></b><span style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;color:windowtext">.</span><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-fareast-font-family:&quot;Times New Roman&quot;;color:windowtext"> 90 healthy term patients undergoing elective CD were randomly allocated into two groups of 45 each.Group A- 45 patients receiving bolus oxytocin 3IU.Group B- 45 patients receiving bolus oxytocin 5IU. Uterine tone was assessed by a blinded obstetrician using a verbal numerical scale score.Minimum effective doses of oxytocin were analysed .Oxytocin related side effects<span style="mso-spacerun:yes">&nbsp; </span>were noted.<o:p></o:p></span></p> <p class="MsoNormal"><b style="mso-bidi-font-weight:normal"><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-fareast-font-family:&quot;Times New Roman&quot;;color:windowtext">Results</span></b><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-fareast-font-family:&quot;Times New Roman&quot;;color:windowtext">Our results indicate that adequate UT can be achieved with small bolus dose (3 units) of oxytocin in patients undergoing elective CD. The results of this study suggest that the use of 5 units oxytocin as a standard dose to achieve adequate UT during elective CD is excessive and re-evaluation of dosing requirement is necessary. In our study, the incidence of hypotension at 1 min was significantly greater in patients receiving 5 units oxytocin compared with 3 units.Other oxytocin-related side-effects (nausea, vomiting, and flushing) occurred rarely with a bolus dose of 3 units in this study. <o:p></o:p></span></p> <p class="MsoNormal"><b style="mso-bidi-font-weight:normal"><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-fareast-font-family:&quot;Times New Roman&quot;;color:windowtext">Conclusion</span></b><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-fareast-font-family:&quot;Times New Roman&quot;;color:windowtext">The routine use of 5 units oxytocin during elective caesarean delivery can be replaced by lower 3 units dose of oxytocin to achieve adequate uterine tone with lesser side effects.</span><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;color:windowtext"><o:p></o:p></span></p>