The Hemodynamic Effects of Oxytocin and Carbetocin during Cesarean Delivery under Regional Anesthesia: A Double-Blinded, Randomized StudyJournal: International Journal of Science and Research (IJSR) (Vol.7, No. 7)
Publication Date: 2018-07-05
Authors : Mahmoud Hussein Bahr; Amira Fouad Elgamel; Mohammed Salah Mohammed Ibrahim;
Page : 1530-1536
Keywords : Oxytocin; Carbetocin; Postpartum Hemorrhage;
Background: Oxytocin is a nine-amino-acid peptide generated in hypothalamic neurons and transferred down posterior pituitary axons before being secreted into the bloodstream. Oxytocin is also secreted from the brain and a few other tissues, including the testes and ovaries. Carbetocin is a long-acting synthetic analog of oxytocin that can be injected intravenously or intramuscularly as a single dose. Carbetocin has a half-life of about 40 minutes when administered intravenously, which is about 4?10 times longer than the half-life of oxytocin. Both drugs are used to prevent and manage post-partum hemorrhage (PPH); it has been recorded that both drugs had similar hemodynamic effects. This research aims to compare the hemodynamic effects of carbetocin and oxytocin throughout elective cesarean delivery under regional anesthesia in a double-blind, randomized controlled trial. Method: A total of 80 patients, ASA I underwent elective cesarean section under spinal anesthesia, were included in this research. The patients were randomly assigned to two evenly distributed groups. Group A received oxytocin (Syntocinon Novartis Pharmaceuticals Ltd. ) (5 IU) as an IV bolus dose over 10 seconds in 10 ml 0.9% NaCl solution, and group B received carbetocin (PabalFerring pharmaceutical Ltd. ) 100 ?g as an IV bolus dose over 10 seconds in 10 ml 0.9% NaCl solution. Results: At the start of the study and the end of the operation, no statistically meaningful change in systolic, diastolic, mean of blood pleasure, or HR. As both drugs increased HR (p-value was 0.063) and decreased BP (P-value 0.109 in SBP, 0.326 in DPB, 0.343 in mean BP). Conclusion: This study concluded that iv administration of a bolus of both oxytocin (5 IU) or carbetocin (100 Mcg) over 10 seconds during the elective cesarean section for ASA I patients; have comparable hemodynamic effects (hypotension and tachycardia), and there was no statistically significant difference between the two drugs with the previous doses regarding MI symptoms, hypotensive effects, blood loss orHB difference levels pre and postoperative, and both drugs have the same good prophylactic effect from PPH.
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