Abstract:
Objective: To determine the lowest effective bolus dose of oxytocin to produce adequate uterine tone during elective
caesarean delivery avoiding side effects.
Study design and setting: A study was conducted at Rawal General and Dental Hospital, from 10th Oct, 2018 to 27th
May, 2019.
Methodology: Patients undergoing elective cesarean spinal delivery were randomly divided by computer generated
numbers(n=155) into 5 groups A, B, C, D and E receiving 0.5, 1, 3, 5 and 10 units of injection oxytocin as bolus respectively
after delivery of baby. Uterine contraction was assessed by gynecologist by manual palpation of uterus on a linear scale.
Value of 8 was considered adequate and 8 inadequate uterine tone respectively. Heart rate, non-invasive blood pressure
and oxygen saturation were noted before and after oxytocin bolus. All patients received oxytocin infusion. The primary
outcome measure was the assessment of uterine tone at 2 minute of oxytocin bolus. The secondary outcome variables
included shortness of breath, chest discomfort, top-up bolus administered, hemodynamic variables, epigastric discomfort
and oxytocin related effects (tachycardia, epigastric discomfort and hypotension).
Results: The use of 5 units oxytocin (group-D) showed most optimal uterine contractions, 61.3% in comparison to commonly
used 10 units bolus dose (group-E) 48.4% with minimal side effects like, less tachycardia(12.9% versus 72.9%) and
hypotension (12.9% versus 32.3%), no top-up bolus dose was required in 54.8% cases and no complain of epigastric
discomfort was observed.
Conclusion: Low doses of oxytocin are effective in terms of uterine contraction with minimal side effects
