OXYTOCIN IV BOLUS VS INFUSION;

HAEMODYNAMIC EFFECTS IN WOMEN UNDERGOING CAESAREAN SECTION

Abstract

Introduction: Obstetric texts advocate the use of oxytocin, either intramuscularly or as a dilute infusion, but warn against the use
of intravenous bolus oxytocin, fearing significant maternal hemodynamic consequences. Objective: To compare the hemodynamic effects of
oxytocin given intravenous bolus versus infusion form. Study design: Randomized clinical trial. Setting: Study was conducted in main
operation theatre and OPD of Combined Military Hospital, Rawalpindi. Duration of study: Study was carried out over a period of six months
from 24-03-2009 to 23-09-2009. Subjects and methods: Total 138 patients were included in this study. Patients were divided into two groups
(Group-A received oxytocin as bolus of 5 iu given as quickly as possible (approximately over 1 s) and in group-B 5 iu diluted to 20ml normal
saline given over 5 minute using an infusion pump). Each group comprised of 69 patients. Results: Mean age of the patients in group-A was
27.3±1.8 and in group-B, 26.9±1.7. Heart rate (beast/min) effect of oxytocin given intravenous bolus vs infusion showed statistically significant
difference from 1 minute to 15 minute (P<0.001). Similarly mean arterial pressure (MAP) rate (beast/min) effect of oxytocin given intravenous
bolus vs infusion also showed statistically significant difference from 1 minute to 15 minute (P<0.001). Conclusions: In conclusion, we found
that at elective Caesarean section, 5 iu of i.v. oxytocin results in less haemodynamic change than 5 iu diluted to 20ml normal saline given over 5
min using as an infusion pump.