The hemodynamics of oxytocin and other vasoactive agents during neuraxial anesthesia for cesarean delivery: findings in six cases

Archer, T. L.; Knape, Kelly G.; Liles, Darla; Wheeler, Andrew A.; Carter, B.

doi:10.1016/j.ijoa.2008.03.003

Cited by 41 publications

(33 citation statements)

References 15 publications

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“…Nevertheless, we feel that bioimpedance use is justified in our healthy patient population. A recent case report has illustrated the value and benefit of arterial pressure wave ''pulse contour analysis'', 1 and we feel that validation studies measuring the correlation are required in obstetric and non-obstetric populations.…”

Section: Discussionmentioning

confidence: 98%

“…Rapid bolus injection of oxytocin results in marked vasodilatation of arteries and capacitance vessels. Arterial vasodilatation increases cardiac output up to two-fold, 1 whereas vasodilatation of capacitance vessels decreases venous return, leading to a fall in blood pressure, increase in heart rate and, in some patients, myocardial ischaemia. 2 In response to a reported death following oxytocin administration, the 1997-99 Report on Confidential Enquiries into Maternal Deaths (CEMD) recommended that the i.v.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Maternal haemodynamics at elective caesarean section: a randomised comparison of oxytocin 5-unit bolus and placebo infusion with oxytocin 5-unit bolus and 30-unit infusion

McLeod

Munishankar

MacGregor

et al. 2010

International Journal of Obstetric Anesthesia

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Maternal haemodynamics at elective caesarean section: a randomised comparison of oxytocin 5-unit bolus and placebo infusion with oxytocin 5-unit bolus and 30-unit infusion

McLeod

Munishankar

MacGregor

et al. 2010

International Journal of Obstetric Anesthesia

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“…5 Oxytocin, given as an intravenous bolus, causes transient hypotension, a reflex tachycardia and an increase in cardiac output, in healthy women undergoing caesarean section under spinal anaesthesia. [6][7][8] The magnitude of these effects is dose-related. 6,9 Coronary vaso-constriction has also been described following oxytocin administration.…”

Section: Introductionmentioning

confidence: 99%

ST depression at caesarean section and the relation to oxytocin dose. A randomised controlled trial

Jonsson

Hanson

Lidell

et al. 2009

BJOG

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Objective To investigate whether there is a difference in occurrence of electrocardiogram changes suggestive of myocardial ischaemia between two different doses of oxytocin.Design Double-blind randomised controlled trial Setting University hospital in Sweden.Population A total of 103 healthy women undergoing elective caesarean section under spinal anaesthesia.Methods The participants were randomised to 5 or 10 units of oxytocin, given as an intravenous bolus. A Holter monitor was used to record electrocardiograms and non invasive blood pressure and heart rate (HR) was monitored. A blood sample was obtained 12-hour postoperatively.Main outcome measures Depression of the ST segment. Secondary outcomes: symptoms, Troponon I levels, mean arterial pressure (MAP), HR and blood loss.Results There was a significant difference in occurrence of ST depressions associated with oxytocin administration, 4 (7.7%) with 5 and 11 (21.6%) with 10 units, P < 0.05. The absolute risk reduction was 13.9% (95% confidence interval, 0.5-27.3). Decrease of mean MAP from baseline to 2 minutes differed, being 9 mmHg in the 5 unit group and 17 mmHg in the 10 unit group (P < 0.01). The increase in mean HR did not differ. Troponin I levels were increased in four subjects (3.9%). There were no differences in occurrence of symptoms, Troponin I levels, or estimated blood loss.Conclusion ST depressions were associated with oxytocin administration significantly more often in subjects receiving 10 units compared with 5 units. Interventions to prevent hypotension during caesarean section may reduce the occurrence of ST depressions on electrocardiograms.

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“…Early studies used transthoracic bioimpedance and thermodilution technology. 9,10 More recently, beat by beat pulse wave form monitors, [11][12][13] and additional studies using transthoracic bioimpedance, 12,14 have provided a clinical picture of peripheral vasodilatation, hypotension, and increased cardiac output mediated by an increase in heart rate and stroke volume. Pulmonary artery pressures are markedly increased and stay so for at least 10 min after a bolus of 10 IU during general anaesthesia.…”

Section: Oxytocinmentioning

confidence: 99%

The use of uterotonic drugs during caesarean section

Dyer

Dyk

Dresner

2010

International Journal of Obstetric Anesthesia

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The hemodynamics of oxytocin and other vasoactive agents during neuraxial anesthesia for cesarean delivery: findings in six cases

Cited by 41 publications

References 15 publications

Maternal haemodynamics at elective caesarean section: a randomised comparison of oxytocin 5-unit bolus and placebo infusion with oxytocin 5-unit bolus and 30-unit infusion

Maternal haemodynamics at elective caesarean section: a randomised comparison of oxytocin 5-unit bolus and placebo infusion with oxytocin 5-unit bolus and 30-unit infusion

ST depression at caesarean section and the relation to oxytocin dose. A randomised controlled trial

The use of uterotonic drugs during caesarean section

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