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BJA Advance Access originally published online on December 2, 2006
British Journal of Anaesthesia 2007 98(1):116-119; doi:10.1093/bja/ael302
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Haemodynamic effects of oxytocin given as i.v. bolus or infusion on women undergoing Caesarean section

J. S. Thomas*, S. H. Koh and G. M. Cooper

Department of Anaesthesia, Birmingham Women's Hospital Metchley Park Road, Edgbaston, Birmingham B15 2TG, UK

*Corresponding author: Department of Anaesthesia, Worcestershire Royal Hospital, Charles Hastings Way, Worcester WR5 1DD, UK. E-mail: jstgasman{at}btinternet.com

Background. The cardiovascular effects of oxytocin in animal models and women undergoing Caesarean section include tachycardia, hypotension and decrease in cardiac output. These can be sufficient to cause significant compromise in high-risk patients. We aimed to find a simple way to decrease these risks whilst retaining the benefits of oxytocin in decreasing bleeding after delivery.

Method. We recruited 30 women undergoing elective Caesarean section. They were randomly allocated to receive 5 u of oxytocin either as a bolus injection (bolus group) or an infusion over 5 min (infusion group). These women had their heart rate and intra-arterial blood pressure recorded every 5 s throughout the procedure. The haemodynamic data, along with the estimated blood loss, were compared between the groups.

Results. Marked cardiovascular changes occurred in the bolus group; the heart rate increased by 17 (10.7) beats min–1 [mean (SD)] compared with 10 (9.7) beats min–1 in the infusion group. The mean arterial pressure decreased by 27 (7.6) mm Hg in the bolus group compared with 8 (8.7) mm Hg in the infusion group. There were no differences in the estimated blood loss between the two groups.

Conclusion. We recommend that bolus doses should be used with caution, and further studies should ascertain if oxytocin is equally effective in reducing blood loss when given at a slower rate.


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E-letters:

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Oxytocin bolus vs infusion in obstetric anaesthesia
Surendra Singh
British Journal of Anaesthesia, 7 Dec 2006 [Full text]
Effects of Oxytocin bolus Vs. infusion on cardiovascular system
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British Journal of Anaesthesia, 22 Jan 2007 [Full text]
Ephedrine can contribute to tachycardia
Dr. M.Rahim Kayani
British Journal of Anaesthesia, 26 Jan 2007 [Full text]
Haemodynamic changes with oxytocin bolus after Caesarean section : A case report
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British Journal of Anaesthesia, 29 Jan 2007 [Full text]
Re: Ephedrine can contribute to tachycardia
Jeremy S Thomas
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