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A comparative study of haemodynamic effects between two different doses of oxytocin in lower segment caesarian section under spinal anaesthesia

A comparative study of haemodynamic effects between two different doses of oxytocin in lower segment caesarean section under spinal anaesthesia. There is always a discussion within the obstetric anaesthesia community about the correct dose of oxytocin and its method of administration. Oxytocin may c...

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Main Author:	Zainudin, Asmah
Format:	Thesis
Language:	English
Published:	2012
Subjects:	R Medicine (General) RD520-599.5 Surgery by region, system, or organ
Online Access:	http://eprints.usm.my/60963/1/DR%20ASMAH%20BINTI%20ZAINUDIN%20-%20e.pdf http://eprints.usm.my/60963/
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spelling	my.usm.eprints.60963 http://eprints.usm.my/60963/ A comparative study of haemodynamic effects between two different doses of oxytocin in lower segment caesarian section under spinal anaesthesia Zainudin, Asmah R Medicine (General) RD520-599.5 Surgery by region, system, or organ A comparative study of haemodynamic effects between two different doses of oxytocin in lower segment caesarean section under spinal anaesthesia. There is always a discussion within the obstetric anaesthesia community about the correct dose of oxytocin and its method of administration. Oxytocin may cause adverse cardiovascular effects, including tachycardia and hypotension, whereas an inadequate dose can result in increased uterine bleeding. We compared the effects of two doses of oxytocin in a randomised doubleblind trial. Seventy patients undergoing elective lower segment caesarean section received an intravenous bolus of either 10 unit or 2 unit of oxytocin after cord clamping. followed by oxytocin infusion 10 unit per hour. All patients received spinal anaesthesia. phenylephrine was used if the blood pressure fell more than 15% from the baseline. We compared changes in heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, uterine tone, blood loss, additional usage of uterotonic drugs and emetic symptoms. There was a larger decrease in MAP in patients who received 10 unit, MD — 12.54 mmHg (15.1%), p value <0.0001 than in those who received 2 unit, MD= - 5.46 mmHg (7.1 %), p value = 0.023 There was a greater increase in mean heart rate in patients who received 10 unit , MD - +9.20 bpm (10.2%), p value <0.0001 than in those who received 2 unit , MD= -+8.23 bpm (9.5%), p value = 0.004. Maximum increase in HR was at 2 minutes (+15.57 bpm, 17.28%).The frequency of antiemetic use was higher after 10 unit (27.6%) than 2 unit (2.9%), (/?=0.042). There was no difference in blood loss, uterine tone, or request for additional uterotonic drugs in both groups. In elective lower segment caesarean under spinal anaesthesia with low risk for post-partum haemorrhage, a 2 unit bolus of oxytocin results in less haemodynamic changes than 10 unit, with less nausea and no difference in uterine tone, estimated blood loss and the need for additional uterotonics drugs. 2012-05 Thesis NonPeerReviewed application/pdf en http://eprints.usm.my/60963/1/DR%20ASMAH%20BINTI%20ZAINUDIN%20-%20e.pdf Zainudin, Asmah (2012) A comparative study of haemodynamic effects between two different doses of oxytocin in lower segment caesarian section under spinal anaesthesia. Masters thesis, Universiti Sains Malaysia.
institution	Universiti Sains Malaysia
building	Hamzah Sendut Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universiti Sains Malaysia
content_source	USM Institutional Repository
url_provider	http://eprints.usm.my/
language	English
topic	R Medicine (General) RD520-599.5 Surgery by region, system, or organ
spellingShingle	R Medicine (General) RD520-599.5 Surgery by region, system, or organ Zainudin, Asmah A comparative study of haemodynamic effects between two different doses of oxytocin in lower segment caesarian section under spinal anaesthesia
description	A comparative study of haemodynamic effects between two different doses of oxytocin in lower segment caesarean section under spinal anaesthesia. There is always a discussion within the obstetric anaesthesia community about the correct dose of oxytocin and its method of administration. Oxytocin may cause adverse cardiovascular effects, including tachycardia and hypotension, whereas an inadequate dose can result in increased uterine bleeding. We compared the effects of two doses of oxytocin in a randomised doubleblind trial. Seventy patients undergoing elective lower segment caesarean section received an intravenous bolus of either 10 unit or 2 unit of oxytocin after cord clamping. followed by oxytocin infusion 10 unit per hour. All patients received spinal anaesthesia. phenylephrine was used if the blood pressure fell more than 15% from the baseline. We compared changes in heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, uterine tone, blood loss, additional usage of uterotonic drugs and emetic symptoms. There was a larger decrease in MAP in patients who received 10 unit, MD — 12.54 mmHg (15.1%), p value <0.0001 than in those who received 2 unit, MD= - 5.46 mmHg (7.1 %), p value = 0.023 There was a greater increase in mean heart rate in patients who received 10 unit , MD - +9.20 bpm (10.2%), p value <0.0001 than in those who received 2 unit , MD= -+8.23 bpm (9.5%), p value = 0.004. Maximum increase in HR was at 2 minutes (+15.57 bpm, 17.28%).The frequency of antiemetic use was higher after 10 unit (27.6%) than 2 unit (2.9%), (/?=0.042). There was no difference in blood loss, uterine tone, or request for additional uterotonic drugs in both groups. In elective lower segment caesarean under spinal anaesthesia with low risk for post-partum haemorrhage, a 2 unit bolus of oxytocin results in less haemodynamic changes than 10 unit, with less nausea and no difference in uterine tone, estimated blood loss and the need for additional uterotonics drugs.
format	Thesis
author	Zainudin, Asmah
author_facet	Zainudin, Asmah
author_sort	Zainudin, Asmah
title	A comparative study of haemodynamic effects between two different doses of oxytocin in lower segment caesarian section under spinal anaesthesia
title_short	A comparative study of haemodynamic effects between two different doses of oxytocin in lower segment caesarian section under spinal anaesthesia
title_full	A comparative study of haemodynamic effects between two different doses of oxytocin in lower segment caesarian section under spinal anaesthesia
title_fullStr	A comparative study of haemodynamic effects between two different doses of oxytocin in lower segment caesarian section under spinal anaesthesia
title_full_unstemmed	A comparative study of haemodynamic effects between two different doses of oxytocin in lower segment caesarian section under spinal anaesthesia
title_sort	comparative study of haemodynamic effects between two different doses of oxytocin in lower segment caesarian section under spinal anaesthesia
publishDate	2012
url	http://eprints.usm.my/60963/1/DR%20ASMAH%20BINTI%20ZAINUDIN%20-%20e.pdf http://eprints.usm.my/60963/
_version_	1816131393930919936
score	13.244413

A comparative study of haemodynamic effects between two different doses of oxytocin in lower segment caesarian section under spinal anaesthesia

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