Maintenance infusion rate of oxytocin after initial 1-IU bolus for elective Cesarean delivery: a dose-finding study
Authors' conclusion
This infusion rate is four-fold lower than that required without an initial bolus.
Study context
- Population
- Patients undergoing elective Cesarean delivery (CD) under spinal anaesthesia receiving a 1-IU oxytocin bolus after deliveryanalysed
- Participants
- 40 patients
- Outcome
- Satisfactory uterine tone (obstetrician palpation); ED90 of oxytocin maintenance infusion
- Follow-up
- From 5 min after delivery until PACU discharge
Methodological detailsprospective, double-blind, biased coin up-down design, 1-IU oxytocin bolus then maintenance infusion; dose increased by 2 IU·hr-1 after unsatisfactory response, decreased by 2 IU·hr-1 with probability 1/9 after satisfactory response
- Prospective
- Double-blind
- Biased coin up-down design
- 1-IU oxytocin bolus then maintenance infusion; dose increased by 2 IU·hr-1 after unsatisfactory response, decreased by 2 IU·hr-1 with probability 1/9 after satisfactory response
Main finding
As reported in the abstract
ED90 of oxytocin maintenance infusion
ED90 of oxytocin maintenance infusion
4.5 IU·hr-1
95% CI 3.3 to 5.5
Observational data: associations, not effects.
Secondary outcomes
Blood loss
- Median [IQR] blood loss
- 861 [553-1,181] mL
Need for additional uterotonics
- Received additional uterotonics
- 18%
Safety
- Developed hypotension post delivery
- 38%
Original publication
Maintenance infusion rate of oxytocin after initial 1-IU bolus for elective Cesarean delivery: a dose-finding study. Can J Anaesth. Published 19 September 2024. doi:10.
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