Volume : III, Issue : II, February - 2014

Oxytocin in Caesarean Section : the “Less Is More” Regimen

Dr. Tahil Ali Khan, Dr. Ruchi Tandon, Dr. Shikha Mehrotra

Abstract :

INTRODUCTION AND OBJECTIVE : Oxytocin remains the uterotonic of choice to prevent uterine atony in caesarean delivery and its prophylactic and therapeutic administration is justified because it reduces the incidence of PPH. However the ideal infusion regimen in elective caesarian sections has not been determined yet. The extrauterine effects of oxytocin specially hypotension and tachycardia are significant, particularly when administered in high doses or in bolus, more so in parturient with hypovolemia or preexisting alterations in CVS. Several dosing regimens have been studied, varying the dose and/or the rate of administration, in an attempt to establish the most adequate. The objective of this study was to compare the hemodynamic effects, uterine tone and adverse effects between two doses of oxytocin (5 IU versus 3 IU in 15 ml NS over 5 min) in parturients undergoing caesarian section under Sub Arachnoid Block. MATERIAL AND METHODS : After taking informed consent, 80 parturients without any known risk factors for uterine atony, scheduled to undergo caesarean section under subarachnoid block, were randomly divided into 2 groups on the basis of dose of oxytocin to be given at the time of cord clamping GROUP O5: Receiving 5 IU of oxytocin in 15 ml RL over 5 min GROUP O3: Receiving 3 IU of oxytocin in 15 ml RL over 5 min Uterine tone was assessed by a blinded obstetrician as either adequate or inadequate at 3 and 5 minutes after oxytocin infusion. Hemodynamic variables (heart rate, blood pressure) , oxytocin related effects(uterine tone, need for additional uterotonic drugs, blood loss) and adverse effects were recorded. RESULTS AND CONCLUSION : We observed that oxytocin infusion 3U results in less hemodynamic response than oxytocin 5U although the difference was not statistically significant. Our results indicate that adequate uterine tone can be achieved with small doses of oxytocin in patients undergoing caesarean section. The results of this study suggest that the use of 5 units oxytocin as a standard dose to achieve adequate uterine tone during CS is excessive and reevaluation of dosing is required.

Keywords :

Article: Download PDF   DOI : 10.36106/ijsr  

Cite This Article:

Dr. Tahil Ali Khan, Dr. Ruchi Tandon, Dr. Shikha Mehrotra Oxytocin in Caesarean Section :the “Less Is More” Regimen International Journal of Scientific Research, Vol.III, Issue.II February 2014

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