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The Median Effective Dose of Oxytocin Needed to Prevent Uterine Atony During Cesarean Delivery in Elderly Parturients

PURPOSE: Oxytocin is the first-line agent to prevent and treat uterine atony during cesarean delivery (CD). We compared the effective dose in 50% of the parturients (ED(50)) of a prophylactic oxytocin bolus during CD in young (<35 years) and old parturients (≥35 years) using Dixon’s up-and-down m...

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Autores principales: Wei, Chang Na, Deng, Jia Li, Dong, Jin Hua, Ping, Ze Peng, Chen, Xin Zhong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7737550/
https://www.ncbi.nlm.nih.gov/pubmed/33335388
http://dx.doi.org/10.2147/DDDT.S258651
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author Wei, Chang Na
Deng, Jia Li
Dong, Jin Hua
Ping, Ze Peng
Chen, Xin Zhong
author_facet Wei, Chang Na
Deng, Jia Li
Dong, Jin Hua
Ping, Ze Peng
Chen, Xin Zhong
author_sort Wei, Chang Na
collection PubMed
description PURPOSE: Oxytocin is the first-line agent to prevent and treat uterine atony during cesarean delivery (CD). We compared the effective dose in 50% of the parturients (ED(50)) of a prophylactic oxytocin bolus during CD in young (<35 years) and old parturients (≥35 years) using Dixon’s up-and-down method. PATIENTS AND METHODS: Twenty-eight young parturients (young group) and 25 old parturients (old group) undergoing CD under combined spinal-epidural anesthesia were enrolled. The initial oxytocin bolus was 0.5 IU, with increments or decrements of 0.25 IU. Maternal adverse effects, requirement for additional uterotonic agents, and estimated blood loss were recorded. RESULTS: The ED(50) for oxytocin in the old group was higher than that in the young group (1.41 IU; 95% confidence interval, 0.63–2.19) vs 0.66 IU (0.04–1.29), P < 0.001). The total oxytocin dose in the old group was higher than in the young group (5.9 ± 2.9 vs 4.1 ± 2.1 IU, P = 0.01). The estimated blood loss in the older group and young group was 401.2 ± 204.5 mL and 289.3 ± 104.6 mL, respectively (P =0.01). The overall prevalence of adverse effects was higher in the old group than in the young group (68.0% vs 21.4%, P < 0.001). CONCLUSION: The initial bolus and total requirement of oxytocin for preventing uterine atony were higher in old parturients than in young parturients during CD. Advanced maternal age may necessitate higher doses of oxytocin.
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spelling pubmed-77375502020-12-16 The Median Effective Dose of Oxytocin Needed to Prevent Uterine Atony During Cesarean Delivery in Elderly Parturients Wei, Chang Na Deng, Jia Li Dong, Jin Hua Ping, Ze Peng Chen, Xin Zhong Drug Des Devel Ther Original Research PURPOSE: Oxytocin is the first-line agent to prevent and treat uterine atony during cesarean delivery (CD). We compared the effective dose in 50% of the parturients (ED(50)) of a prophylactic oxytocin bolus during CD in young (<35 years) and old parturients (≥35 years) using Dixon’s up-and-down method. PATIENTS AND METHODS: Twenty-eight young parturients (young group) and 25 old parturients (old group) undergoing CD under combined spinal-epidural anesthesia were enrolled. The initial oxytocin bolus was 0.5 IU, with increments or decrements of 0.25 IU. Maternal adverse effects, requirement for additional uterotonic agents, and estimated blood loss were recorded. RESULTS: The ED(50) for oxytocin in the old group was higher than that in the young group (1.41 IU; 95% confidence interval, 0.63–2.19) vs 0.66 IU (0.04–1.29), P < 0.001). The total oxytocin dose in the old group was higher than in the young group (5.9 ± 2.9 vs 4.1 ± 2.1 IU, P = 0.01). The estimated blood loss in the older group and young group was 401.2 ± 204.5 mL and 289.3 ± 104.6 mL, respectively (P =0.01). The overall prevalence of adverse effects was higher in the old group than in the young group (68.0% vs 21.4%, P < 0.001). CONCLUSION: The initial bolus and total requirement of oxytocin for preventing uterine atony were higher in old parturients than in young parturients during CD. Advanced maternal age may necessitate higher doses of oxytocin. Dove 2020-12-08 /pmc/articles/PMC7737550/ /pubmed/33335388 http://dx.doi.org/10.2147/DDDT.S258651 Text en © 2020 Wei et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Wei, Chang Na
Deng, Jia Li
Dong, Jin Hua
Ping, Ze Peng
Chen, Xin Zhong
The Median Effective Dose of Oxytocin Needed to Prevent Uterine Atony During Cesarean Delivery in Elderly Parturients
title The Median Effective Dose of Oxytocin Needed to Prevent Uterine Atony During Cesarean Delivery in Elderly Parturients
title_full The Median Effective Dose of Oxytocin Needed to Prevent Uterine Atony During Cesarean Delivery in Elderly Parturients
title_fullStr The Median Effective Dose of Oxytocin Needed to Prevent Uterine Atony During Cesarean Delivery in Elderly Parturients
title_full_unstemmed The Median Effective Dose of Oxytocin Needed to Prevent Uterine Atony During Cesarean Delivery in Elderly Parturients
title_short The Median Effective Dose of Oxytocin Needed to Prevent Uterine Atony During Cesarean Delivery in Elderly Parturients
title_sort median effective dose of oxytocin needed to prevent uterine atony during cesarean delivery in elderly parturients
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7737550/
https://www.ncbi.nlm.nih.gov/pubmed/33335388
http://dx.doi.org/10.2147/DDDT.S258651
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