Yaliwal Rajasri G, Biradar Aruna M, Dharmarao Prathibha S, Kori Shreedevi S, Mudanur Subhashchandra R, Patil Neelamma G, Shiragur Shobha S, Mathapati Sangamesh S
Department of OBGYN, BLDE (DU) Shri B. M. Patil Medical College Hospital and Research Center, Vijayapura, Karnataka, India.
Department of Anesthesiology, BLDE (DU) Shri B. M. Patil Medical College Hospital and Research Center, Vijayapura, Karnataka, India.
Int J Womens Health. 2020 Nov 18;12:1091-1097. doi: 10.2147/IJWH.S280842. eCollection 2020.
Oxytocin is the preferred choice for prophylaxis and treatment of postpartum hemorrhage. Intravenous infusion has been a widely accepted route for Oxytocin administration. However, intravenous bolus route is not a readily preferred route due to apprehensions regarding hypotension that it may cause. This trial compares low dose 3 IU intravenous (IV) bolus Oxytocin along with 7 IU Oxytocin in intravenous infusion to 10IU Oxytocin intravenous infusion during cesarean section.
A total of 250 term pregnant women were randomized to either 3 IU intravenous bolus with 7 IU intravenous infusion of Oxytocin or 10IU of intravenous Oxytocin infusion. The difference in pre- and post-operative hemoglobin levels, tone of the uterus, hemodynamic changes, adverse effects of the drug, need for additional uterotonics and need for blood transfusions were assessed.
There was 6.7% less blood loss in the 3 IU IV bolus Oxytocin with 7 IU Oxytocin infusion group in comparison to the Oxytocin infusion group. The tone of the uterus was firmer in IV bolus Oxytocin with Oxytocin infusion group at 5 minutes (p<0.001) than the Oxytocin infusion group. There was no significant difference in the hemodynamic changes, adverse effects or need for blood transfusions.
Intravenous bolus of 3 IU Oxytocin along with 7 IU infusion of Oxytocin is as safe and more effective than intravenous infusion of 10 IU of Oxytocin during cesarean section in the prevention of postpartum hemorrhage.
催产素是预防和治疗产后出血的首选药物。静脉输注一直是催产素给药的广泛接受途径。然而，由于担心静脉推注可能导致低血压，它并非首选途径。本试验比较剖宫产术中低剂量3 IU静脉推注催产素联合7 IU催产素静脉输注与10 IU催产素静脉输注的效果。
总共250名足月孕妇被随机分为两组，一组接受3 IU静脉推注联合7 IU催产素静脉输注，另一组接受10 IU催产素静脉输注。评估术前和术后血红蛋白水平的差异、子宫收缩情况、血流动力学变化、药物不良反应、是否需要额外使用宫缩剂以及是否需要输血。
与催产素静脉输注组相比，3 IU静脉推注联合7 IU催产素输注组的失血量减少了6.7%。在5分钟时，静脉推注催产素联合催产素输注组的子宫收缩比催产素输注组更有力（p<0.001）。血流动力学变化、不良反应或输血需求方面无显著差异。
剖宫产术中，静脉推注3 IU催产素联合7 IU催产素输注在预防产后出血方面与静脉输注10 IU催产素一样安全且更有效。
