Comparison of Oxytocin 3IU Bolus + I.V. Infusion 0f 30IU at the Rate of 125 ml/Hr.(0.125 IU/Min.) and oxytocin I.V. infusion at 0.125 IU/Min only, in maintaining uterine tone and hemodynamic stability

Oxytocin is routinely administered during caesarean delivery to initiate uterine contraction and thus decrease the blood loss from the site of placental attachment. Adverse effects are known to occur after I.V. oxytocin administration, depending on the dose and rate of administration. The aim of our study was to compare the effect of oxytocin intravenous bolus +I.V. infusion with oxytocin I.V. infusion alone in maintaining adequate Uterine Tone and Hemodynamic stability in women undergoing elective caesarean delivery. Sixty parturients undergoing caesarean delivery under spinal anesthesia were recruited for our study. They were randomly allocated to receive 3IU of oxytocin as bolus intravenous injection over 15 seconds followed by I.V. infusion of oxytocin at 0.125 IU/min (group B) or placebo followed by I.V. infusion of oxytocin at 0.125 IU/min over 4 hours (group I). Uterine tone was assessed as adequate or inadequate by the attending obstetrician. Intraoperative heart rate, non-invasive blood pressure, amount of blood loss, and any complications were recorded. Postoperatively they were followed for 24 hours for any complications. Results: There was significant rise in heart rate and significant decrease in mean arterial pressure in bolus group compared to infusion group. There was no significant change in the amount of blood loss between the groups. Only one incidence of vomiting occurred in the infusion group. There was a gradual and adequate rise in Uterine tone in both the groups by 15th minute post oxytocin. Conclusion: Infusion of oxytocin raises the uterine tone gradually compared to bolus group. Bolus group shows significantly more adverse cardiovascular events.