Haemodynamic effects of carbetocin and oxytocin given as intravenous bolus on women undergoing caesarean delivery: a randomised trial
- 14 June 2011
- journal article
- research article
- Published by Wiley in BJOG: An International Journal of Obstetrics and Gynaecology
- Vol. 118 (11), 1349-1356
- https://doi.org/10.1111/j.1471-0528.2011.03022.x
Abstract
Objective This study compares the maternal heart rate effects of carbetocin and oxytocin during elective caesarean delivery. Design Double blind randomised single centre study (1:1). Setting University hospital providing intrapartum care. Population Fifty-six women undergoing elective caesarean section after spinal anaesthesia. Methods Haemodynamic parameters were measured non-invasively using the Task Force (R) Monitor 3040i system. Measurements were taken for 500 seconds upon administration of a slow intravenous bolus of the clinically recommended doses of 100 mu g of carbetocin or 5 IU of oxytocin to prevent postpartum haemorrhage (PPH). Main outcome measure Effect on maternal heart rate (HR). Results Statistically indistinguishable haemodynamic effects were seen for both drugs, with a maximal effect at about 30-40 seconds: HR increased 17.98 +/- 2.53 bpm for oxytocin and 14.20 +/- 2.45 bpm for carbetocin. Systolic blood pressure (sBP) decreased (-26.80 +/- 2.82 mmHg for oxytocin versus) -22.98 +/- 2.75 mmHg for carbetocin). Following the maximal effect, women treated with carbetocin recovered slowly to baseline values asymptotically (HR and BP), whereas women treated with oxytocin displayed a slight rebound bradycardia at 200 seconds (-6.8 +/- 1.92 bpm). Patients under both treatments showed a similar profile of side effects without any indication of unexpected adverse effects. Conclusion Both oxytocins have comparable haemodynamic effects and are uterotonic drugs with an acceptable safety profile for prophylactic use. Minimal differences in the recovery phase beyond 70 seconds are in keeping with the fact that carbetocin has an extended half-life compared with oxytocin.Keywords
This publication has 16 references indexed in Scilit:
- Carbetocin versus oxytocin for the prevention of postpartum haemorrhage following caesarean section: the results of a double‐blind randomised trialBJOG: An International Journal of Obstetrics and Gynaecology, 2010
- Minimum effective bolus dose of oxytocin during elective Caesarean deliveryBritish Journal of Anaesthesia, 2010
- Haemodynamic effects of repeated doses of oxytocin during Caesarean delivery in healthy parturientsBritish Journal of Anaesthesia, 2009
- Changes in haemodynamic and autonomous nervous system parameters measured non-invasively throughout normal pregnancyEuropean Journal of Obstetrics & Gynecology and Reproductive Biology, 2009
- Epidemiology of postpartum haemorrhage: a systematic reviewBest Practice & Research Clinical Obstetrics & Gynaecology, 2008
- Signs of myocardial ischaemia after injection of oxytocin: a randomized double-blind comparison of oxytocin and methylergometrine during Caesarean sectionBritish Journal of Anaesthesia, 2008
- Non-invasive beat-to-beat cardiac output monitoring by an improved method of transthoracic bioimpedance measurementComputers in Biology and Medicine, 2005
- Haemodynamic changes caused by oxytocin during caesarean section under spinal anaesthesiaInternational Journal of Obstetric Anesthesia, 2002
- Prophylactic oxytocin for the third stage of labourPublished by Wiley ,2001