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Year 2019

Volume: 6 , Issue: 3

Print ISSN:-2394-4781

Online ISSN:-2394-4994

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Indian Journal of Clinical Anaesthesia


Comparison of uterotonic effects of three low dose oxytocin regimens; bolus plus continuous infusion, bolus or continuous infusion during elective caesarean section: A double blind randomized control


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Author Details: Jayesh Shakeet, Rakhi Bansal, Mridul Janweja, Sarita Janweja

Volume : 4

Issue : 1

Online ISSN : 2394-4994

Print ISSN : 2394-4781

Article First Page : 94

Article End Page : 98


Abstract

Background: Oxytocin is considered the drug of choice for managing post-partum hemorrhage resulting from uterine atony, but optimum regimen of oxytocin is yet to be uncovered. Here our primary aim was to compare the uterotonic effects (uterine tone, use of rescue drugs, and intra-operative blood loss) of three low dose different regimens of oxytocin.
Methods and Material: It was a double blind randomized control trial conducted in tertiary care teaching hospital. One hundred and twenty primi/second gravida mothers, age group 18-40 years, ASA grade II and height between 1.52 to 1.72 meters, scheduled to undergo elective caesarean section under spinal anesthesia were randomized in to three groups based on oxytocin regimen administered; group A- 3 IU bolus plus 5 IU infusion, group B- 3 IU bolus and group C -5 IU infusion. Fishers exact test was used to compare the proportion between the groups and quantitative data were compared by using Kruskal-Wallis test.
Results: At 2 minutes the percentage of subjects having adequate uterine tone (uterine tone score ≥3) was higher in group A (95%) and B (90%) in comparison to group C (70%) (Fisher exact test, p=0.006). Overall median uterine tone score remained low in group C in comparison to group A and B. Frequency of use of additional uterotonic drugs was equivalent (Fisher exact test, p-0.09) in all the groups but blood loss in group B and C was higher in comparison to group A (P<0.001). Hemodynamic derangements and drug side effects were again proportionate in all the groups (P>0.05).
Conclusions: Bolus plus continuous infusion (3IU plus 5IU) of oxytocin is better uterotonic than either infusion or bolus alone.

Keywords:
Oxytocin, Bolus, Infusion, Uterotonic, Blood loss