Comparison of the Mean Minimum Dose of Bolus Oxytocin for Proper Uterine Contraction during Cesarean Section

Beiranvand, Siavash; Karimi, Arash; Vahabi, Sepideh; Amin-Bidokhti, Arash

doi:10.2174/1574884714666190524100214

Cited by 27 publications

(15 citation statements)

References 18 publications

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“…In another largescale study conducted in Egypt, 10 IU IV bolus oxytocin was found to be superior to 10 IU IM oxytocin in vaginal delivery (9). However, the other systematic review could not establish whether the IV or IM route was superior and concluded that larger randomized control trials were required in this regard (10). The hemodynamics of the patients were stable in both groups and no difference was found between the groups in this regard.…”

Section: Discussionmentioning

confidence: 99%

Randomised Control Trial of 3 IU Intravenous Oxytocin Bolus With 7 IU Oxytocin Infusion Versus 10 IU Intramuscular Oxytocin in the Third Stage of Labour in the Prevention of Postpartum Hemorrhage

Biradar

Yaliwal

Kori

et al. 2020

International Journal of Women’s Health and Reproduction Scienc

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Objectives: Intravenous (IV) oxytocin during vaginal delivery has been rarely used since an intramuscular (IM) route or IV infusion have been preferred in this regard. The trial aimed to compare the low-dose IV bolus 3 IU of oxytocin, along with 7 IU oxytocin infusion with 10 IU oxytocin infusion in cesarean section. Materials and Methods: A parallel control randomized study was conducted on a total of 320 consenting term pregnant women based on the inclusion criteria. The participants were randomized into either 3 IU IV bolus and 7 IU infusion of oxytocin or 10 IU of IM oxytocin following vaginal delivery. The difference in pre- and post-delivery hemoglobin (Hb) levels, tone of the uterus, hemodynamic changes, adverse effects of the drug, and the need for additional uterotonics and blood transfusions were assessed based on the aim of the study. Results: Based on the results, more women with severe blood loss were found in the IM oxytocin group in comparison to the IV bolus with infusion group following vaginal delivery. In addition, more women had a drop in the Hb of 3 gm/dL in the IM oxytocin group compared to the IV bolus-infusion group (11% vs. 4%, odds ratio=0.768, P=0.469) although there was no statistical significance in this respect. The tone of the uterus was firmer in the IV bolus with infusion group at 3 and 5 minutes. Eventually, the difference in hemodynamic changes, side effects, and the need for additional uterotonics or blood transfusions was not significant. Conclusions: In general, an IV bolus of 3 IU with a 7 IU infusion of oxytocin is as safe as and more effective than the IM injection of 10 IU of oxytocin at the time of vaginal delivery for the prevention of postpartum hemorrhage.

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Section: Discussionmentioning

confidence: 99%

Randomised Control Trial of 3 IU Intravenous Oxytocin Bolus With 7 IU Oxytocin Infusion Versus 10 IU Intramuscular Oxytocin in the Third Stage of Labour in the Prevention of Postpartum Hemorrhage

Biradar

Yaliwal

Kori

et al. 2020

International Journal of Women’s Health and Reproduction Scienc

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“…The mean dose of opioid required was least with 10 mg melatonin, followed by 5 mg melatonin and placebo group, showing that melatonin is likely to be associated with dose-dependent decrease in the need of opioid following cesarean section [ 29 ]. The mean time interval between surgery and resumption of the physical activity was also least with high dose of melatonin (10 mg) relative to two other groups [ 30 ]. Side effects were insignificantly correlated in all three groups.…”

Section: Discussionmentioning

confidence: 99%

Effects of preoperative melatonin on postoperative pain following cesarean section: A randomized clinical trial

Kiabi

Emadi

Jamkhaneh

et al. 2021

Annals of Medicine &Amp; Surgery

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Background Data regarding the analgesic effects of melatonin after the surgery is scare. So far, only one study has investigated the analgesic effect of melatonin during cesarean section. Objective : The present study was performed to investigate the effect of preoperative oral melatonin on pain intensity after cesarean section during spinal anesthesia. Methods In a double-blind randomized controlled clinical trial study, 204 patients undergoing elective cesarean section with class 1 and 2 anesthesia (ASA) were enrolled. Patients were randomly divided into 3 groups of 68 patients. Patients in group A were given 5 mg melatonin tablets, patients in group B were given 10 mg melatonin tablets, and group C was given placebo. All patients underwent spinal anesthesia with the same anesthesia protocol. Pain intensity, nausea, vomiting, pruritus and headache were assessed and recorded 2, 6, 12 and 24 h after surgery. The time of first dose of analgesia, the amount of opioid consumed within 24 h, and the time to resume physical activity was also recorded. Statistical analysis of data was performed using SPSS 20 software. Results Repeated measurements of pain intensity during the study showed that in all 3 groups pain intensity was significantly reduced during the study, p < 0.001, respectively. The intensity of pain was significantly different in groups B and C, groups B and A and groups A and C, P < 0.001, respectively. The pain reduction was greatest in group B, followed by group A and group C, respectively. The time interval between the end of surgery and the patient's need for analgesia was significant in group B compared to group A (P = 0.035) and C (P < 0.001) and also in group A compared to group C (P = 0.011). The mean dose of opioid was significantly least in group B, p < 0.001. The mean time to resume physical activity was also shortest in group B, p < 0.001 Headache and nausea/vomiting were observed in 7 patients (10.7%) group A and 7 patients (10.7%) in group C. None of the patients in group B developed complications. Conclusion The results of the present study showed that the use of 10 mg of melatonin before cesarean section with spinal anesthesia is not only safe, but also reduces the severity of patients' pain, increases the duration of postoperative analgesia, reduces the need for analgesics after surgery and resumption of physical activity.

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“…A cross-sectional study carried out by Beiranvand et al concluded that the minimum effective dose is 1 IU, and in those in labor progress 1–1.5 IU, both followed by 20 IU oxytocin in 1000 mL infusion [ 32 ]. The previously mentioned up-down sequential method study of Carvalho also resulted in a small minimum effective dose.…”

Section: Discussionmentioning

confidence: 99%

Prophylactic Dose of Oxytocin for Uterine Atony during Caesarean Delivery: A Systematic Review

Baliulienė

Vitartaitė

Rimaitis

2021

IJERPH

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Objective—to overview, compare and generalize results of randomized clinical trials analyzing different oxytocin doses to prevent postpartum hemorrhage, initiate and maintain uterine contraction after Caesarean delivery. Methods—‘PubMed’, ‘EMBASE’, ‘CENTRAL’, and ‘CINAHL’ electronic databases were searched for clinical trials analyzing the effectiveness of different dose of oxytocin given intravenously during surgery for uterine contraction and to reduce postpartum hemorrhage. A systematic review of relevant literature sources was performed. Results—our search revealed 813 literature sources. A total of 15 randomized clinical trials, comparing different doses of oxytocin bolus and infusion used after caesarean delivery have met the selection criteria. Conclusion—oxytocin bolus 0.5–3 UI is considered an effective prophylactic dose. Recommended effective prophylactic oxytocin infusion dose is 7.72 IU/h, but it is unanswered whether we really need a prophylactic infusion of oxytocin if we choose effective bolus dose size and rate. Adverse hemodynamic effects were observed when a 5 UI oxytocin bolus was used. However, topics such as bolus dose size, infusion dose size and requirement as well as bolus injection rate, still remain unanswered. The doses that are recommended in the guidelines of peripartum hemorrhage prophylaxis are not confirmed by randomized controlled double-blind trials and more research should cover this topic.

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Comparison of the Mean Minimum Dose of Bolus Oxytocin for Proper Uterine Contraction during Cesarean Section

Cited by 27 publications

References 18 publications

Randomised Control Trial of 3 IU Intravenous Oxytocin Bolus With 7 IU Oxytocin Infusion Versus 10 IU Intramuscular Oxytocin in the Third Stage of Labour in the Prevention of Postpartum Hemorrhage

Randomised Control Trial of 3 IU Intravenous Oxytocin Bolus With 7 IU Oxytocin Infusion Versus 10 IU Intramuscular Oxytocin in the Third Stage of Labour in the Prevention of Postpartum Hemorrhage

Effects of preoperative melatonin on postoperative pain following cesarean section: A randomized clinical trial

Prophylactic Dose of Oxytocin for Uterine Atony during Caesarean Delivery: A Systematic Review

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