HEMODYNAMIC EFFECT OF OXYTOCIN GIVEN AS BOLUS WITH INFUSION VERSUS INFUSION ONLY IN PATIENTS UNDERGOING ELECTIVE CAESARIAN SECTION

Background: Oxytocin is the most commonly used uterotonic agent in obstetrics. It is routinely administered after both normal and operative delivery to initiate and maintain adequate uterine contractility for minimizing blood loss and preventing postpartum hemorrhage. Larger dose of oxytocin injected rapidly is known to produce various adverse effects such as hypotension, nausea, vomiting, chest pain, headache, flushing, myocardial ischemia, ST-T segment changes, pulmonary edema, severe water intoxication and convulsions. Aim of the study: Comparison between the effects of oxytocin on hemodynamic stability given either as bolus and continue with infusion or infusion only. Patient and methods: 120 patients undergoing elective C/S under GA was randomly divided into two equal groups (bolus group: giving oxytocin as 5 units direct IV bolus and continue with 10u\hour infusion) and (Infusion group: giving oxytocin as IV infusion of 10u\hour only). Results: oxytocin causes decrement in SBP, DBP, and MAP in both groups after its administration, there was no significant change in HR in the infusion group while there was a significant decrement in HR in the bolus group. The comparison between the two groups showed no significant difference in the change in SBP, DBP and MAP, while there was a significant difference in HR change between the bolus and infusion group in which the HR decrement was significant only in the bolus group. Conclusion: it is concluded that the use of oxytocin IV bolus and continue with infusion can cause a significant decrease in HR in comparison with the use of infusion method without bolus, it is also concluded that both methods caused a significant decrement in SBP, DBP and MAP.