Anesth Pain Med.  2020 Apr;15(2):167-172. 10.17085/apm.2020.15.2.167.

Hemodynamic effects of carbetocin administered as an intravenous bolus or infusion during cesarean delivery

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Korea

Abstract

Background
Postpartum hemorrhage is the leading cause of maternal mortality. Oxytocin being the most popular uterotonic agent, has been routinely administered after both vaginal delivery and cesarean section. Carbetocin is a newer uterotonic agent and provides the benefit of a longer duration of action without additional administration post-delivery.
Methods
We recruited 34 women undergoing elective cesarean section under spinal anesthesia. All patient was received spinal anesthesia using 0.5% hyperbaric Marcaine 8–10 mg in conjugation with fentanyl 20 μg in the left lateral decubitus position. Hartmann’s solution 10–15 ml/kg was administered before carbetocin. The operation started as soon as sensory block at level T4–T6 was confirmed. A non-invasive hemodynamic monitoring cuff (Finometer®) was attached to the patient’s finger soon after the induction of spinal anesthesia. Using the Finometer, we recorded the heart rate and mean arterial pressure at every 15 s, starting from 15 s before the administration of carbetocin to 5 min after. After the removal of the placenta, the bolus group was administered intravenous bolus injection of carbetocin 100 μg and the infusion group was administered carbetocin 100 μg diluted in 50 ml normal saline, over 5 min using an infusion pump.
Results
The demographic data showed no significant difference between the two groups. Furthermore, there were no significant hemodynamic differences between the two groups.
Conclusions
The method of administration of carbetocin does not influence its hemodynamic effects.

Keyword

Carbetocin; Cesarean section; Hypotension; Tachycardia

Figure

  • Fig. 1. Patients CONSORT flow chart.

  • Fig. 2. The changes of heart rate (HR) in two groups. Values are presented as mean ± SD.

  • Fig. 3. The changes of mean arterial pressure (MAP) in two groups. Values are presented as mean ± SD.


Cited by  1 articles

Comparison of the effect of dexmedetomidine and midazolam under spinal anesthesia for cesarean delivery: a randomized controlled trial, single center study in South Korea
Hyoseok Kang, Taeha Lim, Hyun jeong Lee, Tae Wan Kim, Wan Kim, Hae Wone Chang
Anesth Pain Med. 2023;18(2):159-168.    doi: 10.17085/apm.22257.


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