KMID : 1155520200150020167
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Anesthesia and Pain Medicine 2020 Volume.15 No. 2 p.167 ~ p.172
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Hemodynamic effects of carbetocin administered as an intravenous bolus or infusion during cesarean delivery
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Kwon Ki-Hyug
Kim Do-Hyung Jo Hyun-Min Park Ji-Eun Kim Kyung-Ok
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Abstract
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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 ¥ìg 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 ¢ç) 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 ¥ìg and the infusion group was administered carbetocin 100 ¥ìg 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.
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KEYWORD
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Carbetocin, Cesarean section, Hypotension, Tachycardia
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