The effect of oxytocin dose on the ST segment change, arterial hypotension and blood loss in women of different age groups during cesarean section
Issue 3 (2018) , SELECTED ISSUES IN ANESTHESIOLOGY
Issue 3 (2018)
SELECTED ISSUES IN ANESTHESIOLOGY

The effect of oxytocin dose on the ST segment change, arterial hypotension and blood loss in women of different age groups during cesarean section

https://doi.org/10.21320/1818-474X-2018-3-77-86
Published 25.09.2018
Evgeny N. Degtyarev
Amur Regional Clinical Hospital, Perinatal Center, Blagoveschensk
https://orcid.org/0000-0002-7472-3733
E.M. Shifman
M.F. Vladimirskiy Moscow Regional Research Clinical Institute, Moscow
https://orcid.org/0000-0002-6113-8498
G.P. Tikhova
Petrozavodsk State University, Petrozavodsk
https://orcid.org/0000-0003-1128-9666
A.V.Kulikov
Federal State Budgetary Educational Institution of Higher Education “Urals State Medical University” of the Ministry of Healthcare of the Russian Federation, Ekatertinburg
https://orcid.org/0000-0002-7768-4514
#2018-3
PDF_2018-3_77-86 (Русский)

Keywords

oxytocin
young primapara
cesarean section

How to Cite

Degtyarev E.N., Shifman E.M., Tikhova G.P., Kulikov A.V. The effect of oxytocin dose on the ST segment change, arterial hypotension and blood loss in women of different age groups during cesarean section. Annals of Critical Care. 2018;(3):77–86. doi:10.21320/1818-474X-2018-3-77-86.
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Abstract

Oxytocin (OT) is a first-line drug in the prevention and treatment of postpartum hemorrhages. There are a number of studies showing that with prolonged infusion of OT, the concentration of the marker of myocardial damage of troponin and the depression of the ST segment on the ECG increase. As before, the question of hemodynamic effects and the effect on the myocardium of various doses of oxytocin, the concentrations of intravenous microfluidine administration in various categories of parturient women, remains unresolved.

Objective. To conduct a comparative study of the effect of oxytocin dose on ST segment depression, during the operation, cesarean section under spinal anesthesia in somatically healthy primaparous young and optimal reproductive age.

Materials and methods of research. A prospective, randomized study of ST-segment depression after administration of oxytocin was performed in 44 primaparous patients aged 15 to 25 years. Operative delivery was performed routinely under spinal anesthesia using a standard procedure. The conclusion about ST segment depression was made when the segment was located below the isoelectric 0.5 mm. All patients were randomized into 2 groups according to the dose of OT recommended by different clinical recommendations 5 and 10 units.

Results. In our study, the risk of developing acute depression of the ST segment directly depended on the dose of injected uterotonics. Thus, in the group of patients who received RT at a dose of 10 U, the risk of developing depression of the ST segment was 8.6 times higher than in the group where the dose of OT was 5 units. Among young primaparas, the risk of developing depression of the ST segment is 9 times higher with the administration of OT in a dose of 10 units.

Conclusion. Depression of the ST segment (more than 0.5 mm) directly depends on the dose of oxytocin administered during the operation by cesarean section.

https://doi.org/10.21320/1818-474X-2018-3-77-86
PDF_2018-3_77-86 (Русский)

References

  1. C. Vallera, L.O. Choi, C.M. Cha, R.W. Hong. Uterotonic Medications Oxytocin, Methylergonovine, Carboprost, Misoprostol. Anesthesiology Clin. 2017: 35; 207–219.
  2. Шифман Е.М., Куликов А.В., Кругова Л.В. и др. Безопасность применения утеротоников: что должен знать анестезиолог-реаниматолог? Анестезиология и реаниматология. 2017; 62(3): 220–224. [Shifman E.M., Kulikov A.V., Krugova L.V., et. al. Bezopasnostʼ primeneniya uterotonikov: chto dolzhen znatʼ anesteziolog-reanimatolog? Anesteziologiya i reanimatologiya. 2017; 62(3): 220–224. (In Russ)]
  3. Thomas J.S., Koh S.H., Copper G.M. Haemodynamic effects of oxytocin given as i.v. bolus or infusion on women undergoing Caesarean section. Br. J. Anaesth. 2007; 98: 116–119.
  4. Pinder A.J., Dresner M., Calow C., et al. Haemodynamic changes caused by oxytocin during caesarean section under spinal anaesthesia. Int. J. Obstet. Anaesth. 2002; 11: 156–159.
  5. Vercauteren M., Palit S., Soetens F., et al. Anaesthesiological considerations on tocolytic and uterotonic therapy in obstetrics. Acta Anaesth. Scand. 2009; 53: 701–709.
  6. Jonsson M., Hanson U., Lidell C. ST depression at ceaesarean section and the relation to oxytocin dose. A randomised controlled trial. Br. J. Obstet. Gynaecol. 2010; 117: 76–83.
  7. Martinez-Quintana E., Rodriguez-Gonzalez F. Pregnancy and coronary artery dissection. Clin. Invest. Arterioscler. 2015; 27(4): 215–219.
  8. Gizzo S., Patrelli T.S., Gangi S.D., et al. Which Uterotonic Is Better to Prevent the Postpartum Hemorrhage? Latest News in Terms of Clinical Efficacy, Side Effects, and Contraindications. Reprod. Sci. 2013; 20(9): 1011–1019.
  9. Анестезия при операции кесарева сечения . В кн.: Анестезия, интенсивная терапия и реанимация в акушерстве и гинекологии. Клинические рекомендации. Протоколы лечения. Под ред. А.В. Куликова, Е.М. Шифмана. М.: Медицина, 2016: 11–28. [Anesteziya pri operacii kesareva secheniya. In: Anesteziya, intensivnaya terapiya i reanimaciya v akusherstve i ginekologii. Klinicheskie rekomendacii. Protokoly lecheniya. Pod red. A.V. Kulikova, E.M. Shifmana. Moscow: Medicina, 2016: 11–28. (In Russ)]
  10. ЭКГ-диагностика ишемии и инфаркта миокарда: учебное пособие. Под ред. А.В. Синькова. Иркутск, 2015: 5–18. [EKG diagnostika ishemii i infarkta miokarda: Uchebnoe posobie. Pod red. A.V. Sinʼkova. Irkutsk, 2015: 5–18. (In Russ)]
  11. Клинические рекомендации: протоколы лечения «Гипертензивные расстройства во время беременности, в родах и послеродовом периоде. Преэклампсия. Эклампсия». Письмо МЗ РФ от 7 июня 2016 г. № 15-4/10/2-3483.[Klinicheskie rekomendacii: protokoly lecheniya “Gipertenzivnye rasstrojstva vo vremya beremennosti, v rodah i poslerodovom periode. Preehklampsiya. Ehklampsiya”. Pisʼmo MZ RF ot 7 iyunya 2016 g. № 15-4/10/2-3483. (In Russ)]
  12. Клинические рекомендации: протокол лечения «Кесарево сечение. Показания, методы обезболивания, хирургическая техника, антибиотикопрофилактика, ведение послеоперационного периода». Письмо МЗ РФ от 6 мая 2014 г. № 15-4/10/2-3190. [Klinicheskie rekomendacii: protokol lecheniya “Kesarevo sechenie. Pokazaniya, metody obezbolivaniya, hirurgicheskaya tekhnika, antibiotikoprofilaktika, vedenie posleoperacionnogo perioda”. Pisʼmo MZ RF ot 6 maya 2014 g. № 15-4/10/2-3190. (In Russ)]
  13. E.J. Baird. Identification and Management of Obstetric Hemorrhage. Anesthesiology Clin. 2017; 35: 15–34.
  14. Snegovskikh D., Clebone A., Norwitz E. Anesthetic management of patients with placenta accreta and resuscitations strategies for associated massive hemorrhage. Curr. Opin. Anaesthesiol. 2011; 24: 274–281.
  15. Rabow S., Olofsson P. Pulse wave analysis by digital photoplethysmography to record maternal hemodynamic effects of spinal anesthesia, delivery of the baby, and intravenous oxytocin during cesarean section. J. Matern. Fetal Neonat. Med. 2016; 26: 1–8.
  16. Bolton T.J., Randall K., Yentis S.M. Effect of the confidential enquiries into maternal deaths on the use of syntocinon at caesarean section in the UK. Anaesthesia. 2003; 58(3): 277–279.
  17. Sarna M.C., Soni A.K., Gomez M., Oriol N.E. Intravenous oxytocin in patients undergoing elective cesarean section. Anesth. Analg. 1997; 84: 753–756.
  18. E. Zarzur. Intravenous oxytocin in patients undergoing elective caesarean section. Anesth. Analg. 1998; 86: 1334
  19. George R.B., McKeen D., Chaplin A.C., McLeod L. Up-down determination of the ED90 of oxytocin infusions for the prevention of postpartum uterine atony in parturients undergoing cesarean delivery. Can. J. Anesth. 2010; 57: 578–582.
  20. Balki M., Ronayne M., Davies S., et al. Minimum oxytocin dose requirement after cesarean delivery for labor arrest. Obstet. Gynecol. 2006; 107: 45–50.
  21. Yulia A., Johnson M.R. Myometrial oxytocin receptor expression and intracellular pathways. Minerva Ginecol. 2014; 66(3): 267–280.
  22. Ларюшева Е.М., Истомина Н.Г., Баранов А.Н. Течение беременности, родов и перинатальные исходы у подростков Архангельской области — сравнительное исследование через 20 лет. Экология человека. 2016; 08: 40–44. [Laryusheva E.M., Istomina N.G., Baranov A.N. Techenie beremennosti, rodov i perinatalʼnye iskhody u podrostkov Arhangelʼskoj oblasti — sravnitelʼnoe issledovanie cherez 20 let. Ehkologiya cheloveka. 2016; 08: 40–44. (In Russ)]
  23. Ларюшева Е.М., Истомина Н.Г., Баранов А.Н. Сравнительная характеристика клинических показателей течения беременности и родов у женщин подросткового и оптимального репродуктивного возраста. Журнал акушерства и женских болезней. 2016; 65(1): 34–42. [Laryusheva E.M., Istomina N.G., Baranov A.N. Sravnitelʼnaya harakteristika klinicheskih pokazatelej techeniya beremennosti i rodov u zhenshchin podrostkovogo i optimalʼnogo reproduktivnogo vozrasta. Zhurnal akusherstva i zhenskih boleznej. 2016; 65(1): 34–42. (In Russ)]
  24. Rosseland L.A., Hauge T.H. Changes in blood pressure and cardiac output during cesarean delivery. Anesthesiology. 2013; 119: 541–551.
  25. Tsen L., Balki M. Oxytocin protocols during cesarean delivery: time to acknowledge the risk/benefit ratio? IOJA. 2010; 19: 243–245.
  26. Shashikiran, Kaur H., Bala R., Gupta N. A study to determine minimum effective dose of oxytocin infusion during caesarean delivery in parturients at high risk of uterine atony. J. Obstet. Anaesth. Crit. Care. 2017; 7: 75–80.
  27. Kovacheva V.P., Soens M.A., Tsen L.C. A randomized, double-blinded trial of a «rule of threes» algoritm versus continuous infusion of oxytocin during elective cesarean delivery. Anesth. 2015; 123: 92–100.
  28. Gallos I.D., Williams H.M., Price M.J., et al. Uterotonic agents for preventing postpartum haemorrhage: a network meta-analysis. Cochrane Database of Systematic Reviews. 2018; 4: CD011689.
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