Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Friedrich, S.
Haemodynamic assessment at elective Caesarean section: A comparative study after administration of carbetocin versus oxytocin - a doubleblind randomized trial
[ Dissertation ] Medical University of Graz; 2008. pp.
- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Lang Uwe
- Scholz Heinz
- Altmetrics:
- Abstract:
- Background: Oxytocin is recommended as the uterotonic of choice for the prevention of postpartum haemorrhage by most experts, but has some haemodynamic side effects, which might compromise the heath of patients, especially the ones with cardiac diseases of hypovolemia. Current literature reports, that carbetocin has an uterotonic effect, which is at least as god as the one of oxytocin. Furthermore, a preclinical test and single observations show that carbetocin has also a higher safety profile regarding cardiovascular side-effects. But since no clinical trial has been undertaken yet to investigate the haemodynamic side-effects of carbetocin, we conducted this trial to evaluate the oxytocic with the best safety profile. Objective: This study was undertaken, to compare the effect of carbetocin versus oxytocin on maternal haemodynamic parameters in a non-invasive setup (Task Force-Monitor) at elective Caesarean section under spinal anaesthesia. Additionally we compared the effect on myometrial contraction and the incidence of adverse events, experienced by the patient. Methods: In a randomized, double-blind fashion, 28 women received an oxytocin bolus (5 lU oxytocin within one minute) and another 28 women received a carbetocin bolus (100g carbetocin within one minute) after the delivery of the child at elective Caesarean section. Haemodynamic parameters (systolic, diastolic and mean blood pressure, heart rate, stroke volume, stroke index, cardiac output, cardiac index, total peripheral resistance, total peripheral resistance index and of contractility) were measured continuously in a non-invasive setup (Task Force-Monitor). Furthermore, we evaluated the haemoglobin-drop, the incidence of other, non-haemodynamic side-effects. These haemodynamic measurements as well as the other data were anayzed using an independent samples t-test and as a measure of effect size the Pearson-correlation coefficient was used. Results: Oxytocin and carbetocin and had almost the same effect on the cardiovascular system, even though the effect of carbetocin was marginally smaller. But that difference was neither statistically significant nor of clinical relevance. In both groups and both study populations (we compared our entire study population[we called it the entire study groups] and the part of it, which received no further medication during the Caesarean section [we called it the non-meds groups], separately) the total peripheral resistance and total peripheral resistance index decreased by approx.