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ST depression at caesarean section and the relation to oxytocin dose. A randomised controlled trial
Objective To investigate whether there is a difference in occurrence of electrocardiogram changes suggestive of myocardial ischaemia between two different doses of oxytocin. Design Double‐blind randomised controlled trial Setting University hospital in Sweden. Population A total of 103 healthy w...
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| Published in: | BJOG : an international journal of obstetrics and gynaecology 2010-01, Vol.117 (1), p.76-83 |
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| creator | Jonsson, M Hanson, U Lidell, C Nordén‐Lindeberg, S |
| description | Objective To investigate whether there is a difference in occurrence of electrocardiogram changes suggestive of myocardial ischaemia between two different doses of oxytocin.
Design Double‐blind randomised controlled trial
Setting University hospital in Sweden.
Population A total of 103 healthy women undergoing elective caesarean section under spinal anaesthesia.
Methods The participants were randomised to 5 or 10 units of oxytocin, given as an intravenous bolus. A Holter monitor was used to record electrocardiograms and non invasive blood pressure and heart rate (HR) was monitored. A blood sample was obtained 12‐hour postoperatively.
Main outcome measures Depression of the ST segment. Secondary outcomes: symptoms, Troponon I levels, mean arterial pressure (MAP), HR and blood loss.
Results There was a significant difference in occurrence of ST depressions associated with oxytocin administration, 4 (7.7%) with 5 and 11 (21.6%) with 10 units, P |
| doi_str_mv | 10.1111/j.1471-0528.2009.02356.x |
| format | article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_DiVA_org_uu_100466</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1919173791</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4326-929421cae40316e313fad238f3781537f2d9f698db584daf2dffb04acdf237ab3</originalsourceid><addsrcrecordid>eNqNkU1v1DAQhi0Eoh_wF5DFhQsJ_oqTHDhsC-VDlXqgcB059hiyysaLnai7_x5nd1UkTvjimfEz74z1EkI5K3k-79YlVzUvWCWaUjDWlkzISpe7J-T88eHpIWYFk6I5IxcprRnjWjD5nJzxtm44U_Kc2G_31OE2Ykp9GKmZqDWYTEQz0oR2OhRHR6dfSCMO5lCYAg27_RRsP1IXEpZ0RWOmwqZP6KgN4xTDMORwir0ZXpBn3gwJX57uS_L95uP99efi9u7Tl-vVbWGVFLpoRasEz-MVk1yj5NIbJ2TjZV62krUXrvW6bVxXNcqZnHrfMWWs80LWppOX5O1RNz3gdu5gG_uNiXsIpocP_Y8VhPgT5hk4Y0rrjL854tsYfs-YJsjrWxwGM2KYE9RSalVVmmXy9T_kOsxxzH8BITLQCt1kqDlCNoaUIvrH-ZzB4hqsYTEHFnNgcQ0OrsEut7466c_dBt3fxpNNGXh_BB76Aff_LQxXX--WSP4Bn0al0Q</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>225609268</pqid></control><display><type>article</type><title>ST depression at caesarean section and the relation to oxytocin dose. A randomised controlled trial</title><source>Wiley-Blackwell Read & Publish Collection</source><creator>Jonsson, M ; Hanson, U ; Lidell, C ; Nordén‐Lindeberg, S</creator><creatorcontrib>Jonsson, M ; Hanson, U ; Lidell, C ; Nordén‐Lindeberg, S</creatorcontrib><description>Objective To investigate whether there is a difference in occurrence of electrocardiogram changes suggestive of myocardial ischaemia between two different doses of oxytocin.
Design Double‐blind randomised controlled trial
Setting University hospital in Sweden.
Population A total of 103 healthy women undergoing elective caesarean section under spinal anaesthesia.
Methods The participants were randomised to 5 or 10 units of oxytocin, given as an intravenous bolus. A Holter monitor was used to record electrocardiograms and non invasive blood pressure and heart rate (HR) was monitored. A blood sample was obtained 12‐hour postoperatively.
Main outcome measures Depression of the ST segment. Secondary outcomes: symptoms, Troponon I levels, mean arterial pressure (MAP), HR and blood loss.
Results There was a significant difference in occurrence of ST depressions associated with oxytocin administration, 4 (7.7%) with 5 and 11 (21.6%) with 10 units, P < 0.05. The absolute risk reduction was 13.9% (95% confidence interval, 0.5–27.3).
Decrease of mean MAP from baseline to 2 minutes differed, being 9 mmHg in the 5 unit group and 17 mmHg in the 10 unit group (P < 0.01). The increase in mean HR did not differ. Troponin I levels were increased in four subjects (3.9%). There were no differences in occurrence of symptoms, Troponin I levels, or estimated blood loss.
Conclusion ST depressions were associated with oxytocin administration significantly more often in subjects receiving 10 units compared with 5 units. Interventions to prevent hypotension during caesarean section may reduce the occurrence of ST depressions on electrocardiograms.</description><identifier>ISSN: 1470-0328</identifier><identifier>EISSN: 1471-0528</identifier><identifier>DOI: 10.1111/j.1471-0528.2009.02356.x</identifier><identifier>PMID: 19781043</identifier><identifier>CODEN: BIOGFQ</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adult ; Anesthesia, Obstetrical - methods ; Anesthesia, Spinal - methods ; Arrhythmias, Cardiac - blood ; Arrhythmias, Cardiac - chemically induced ; Arrhythmias, Cardiac - physiopathology ; Blood pressure ; Blood Pressure - drug effects ; Caesarean section ; Cesarean Section ; Clinical trials ; Dose-Response Relationship, Drug ; Double-Blind Method ; Drug dosages ; Drug therapy ; Electrocardiography ; Electrocardiography, Ambulatory - drug effects ; Female ; heart ; Humans ; hypotension ; ischaemia ; ischemia ; MEDICIN ; MEDICINE ; Obstetrics and Gynaecology ; Obstetrik och gynekologi ; Oxytocics - administration & dosage ; Oxytocics - adverse effects ; oxytocin ; Oxytocin - administration & dosage ; Oxytocin - adverse effects ; Pregnancy ; regional anaesthesia ; Troponin I - metabolism</subject><ispartof>BJOG : an international journal of obstetrics and gynaecology, 2010-01, Vol.117 (1), p.76-83</ispartof><rights>2009 The Authors Journal compilation © RCOG 2009 BJOG An International Journal of Obstetrics and Gynaecology</rights><rights>Journal compilation © 2009 RCOG</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4326-929421cae40316e313fad238f3781537f2d9f698db584daf2dffb04acdf237ab3</citedby><cites>FETCH-LOGICAL-c4326-929421cae40316e313fad238f3781537f2d9f698db584daf2dffb04acdf237ab3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19781043$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-100466$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Jonsson, M</creatorcontrib><creatorcontrib>Hanson, U</creatorcontrib><creatorcontrib>Lidell, C</creatorcontrib><creatorcontrib>Nordén‐Lindeberg, S</creatorcontrib><title>ST depression at caesarean section and the relation to oxytocin dose. A randomised controlled trial</title><title>BJOG : an international journal of obstetrics and gynaecology</title><addtitle>BJOG</addtitle><description>Objective To investigate whether there is a difference in occurrence of electrocardiogram changes suggestive of myocardial ischaemia between two different doses of oxytocin.
Design Double‐blind randomised controlled trial
Setting University hospital in Sweden.
Population A total of 103 healthy women undergoing elective caesarean section under spinal anaesthesia.
Methods The participants were randomised to 5 or 10 units of oxytocin, given as an intravenous bolus. A Holter monitor was used to record electrocardiograms and non invasive blood pressure and heart rate (HR) was monitored. A blood sample was obtained 12‐hour postoperatively.
Main outcome measures Depression of the ST segment. Secondary outcomes: symptoms, Troponon I levels, mean arterial pressure (MAP), HR and blood loss.
Results There was a significant difference in occurrence of ST depressions associated with oxytocin administration, 4 (7.7%) with 5 and 11 (21.6%) with 10 units, P < 0.05. The absolute risk reduction was 13.9% (95% confidence interval, 0.5–27.3).
Decrease of mean MAP from baseline to 2 minutes differed, being 9 mmHg in the 5 unit group and 17 mmHg in the 10 unit group (P < 0.01). The increase in mean HR did not differ. Troponin I levels were increased in four subjects (3.9%). There were no differences in occurrence of symptoms, Troponin I levels, or estimated blood loss.
Conclusion ST depressions were associated with oxytocin administration significantly more often in subjects receiving 10 units compared with 5 units. Interventions to prevent hypotension during caesarean section may reduce the occurrence of ST depressions on electrocardiograms.</description><subject>Adult</subject><subject>Anesthesia, Obstetrical - methods</subject><subject>Anesthesia, Spinal - methods</subject><subject>Arrhythmias, Cardiac - blood</subject><subject>Arrhythmias, Cardiac - chemically induced</subject><subject>Arrhythmias, Cardiac - physiopathology</subject><subject>Blood pressure</subject><subject>Blood Pressure - drug effects</subject><subject>Caesarean section</subject><subject>Cesarean Section</subject><subject>Clinical trials</subject><subject>Dose-Response Relationship, Drug</subject><subject>Double-Blind Method</subject><subject>Drug dosages</subject><subject>Drug therapy</subject><subject>Electrocardiography</subject><subject>Electrocardiography, Ambulatory - drug effects</subject><subject>Female</subject><subject>heart</subject><subject>Humans</subject><subject>hypotension</subject><subject>ischaemia</subject><subject>ischemia</subject><subject>MEDICIN</subject><subject>MEDICINE</subject><subject>Obstetrics and Gynaecology</subject><subject>Obstetrik och gynekologi</subject><subject>Oxytocics - administration & dosage</subject><subject>Oxytocics - adverse effects</subject><subject>oxytocin</subject><subject>Oxytocin - administration & dosage</subject><subject>Oxytocin - adverse effects</subject><subject>Pregnancy</subject><subject>regional anaesthesia</subject><subject>Troponin I - metabolism</subject><issn>1470-0328</issn><issn>1471-0528</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><recordid>eNqNkU1v1DAQhi0Eoh_wF5DFhQsJ_oqTHDhsC-VDlXqgcB059hiyysaLnai7_x5nd1UkTvjimfEz74z1EkI5K3k-79YlVzUvWCWaUjDWlkzISpe7J-T88eHpIWYFk6I5IxcprRnjWjD5nJzxtm44U_Kc2G_31OE2Ykp9GKmZqDWYTEQz0oR2OhRHR6dfSCMO5lCYAg27_RRsP1IXEpZ0RWOmwqZP6KgN4xTDMORwir0ZXpBn3gwJX57uS_L95uP99efi9u7Tl-vVbWGVFLpoRasEz-MVk1yj5NIbJ2TjZV62krUXrvW6bVxXNcqZnHrfMWWs80LWppOX5O1RNz3gdu5gG_uNiXsIpocP_Y8VhPgT5hk4Y0rrjL854tsYfs-YJsjrWxwGM2KYE9RSalVVmmXy9T_kOsxxzH8BITLQCt1kqDlCNoaUIvrH-ZzB4hqsYTEHFnNgcQ0OrsEut7466c_dBt3fxpNNGXh_BB76Aff_LQxXX--WSP4Bn0al0Q</recordid><startdate>201001</startdate><enddate>201001</enddate><creator>Jonsson, M</creator><creator>Hanson, U</creator><creator>Lidell, C</creator><creator>Nordén‐Lindeberg, S</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>DF2</scope></search><sort><creationdate>201001</creationdate><title>ST depression at caesarean section and the relation to oxytocin dose. A randomised controlled trial</title><author>Jonsson, M ; Hanson, U ; Lidell, C ; Nordén‐Lindeberg, S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4326-929421cae40316e313fad238f3781537f2d9f698db584daf2dffb04acdf237ab3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Anesthesia, Obstetrical - methods</topic><topic>Anesthesia, Spinal - methods</topic><topic>Arrhythmias, Cardiac - blood</topic><topic>Arrhythmias, Cardiac - chemically induced</topic><topic>Arrhythmias, Cardiac - physiopathology</topic><topic>Blood pressure</topic><topic>Blood Pressure - drug effects</topic><topic>Caesarean section</topic><topic>Cesarean Section</topic><topic>Clinical trials</topic><topic>Dose-Response Relationship, Drug</topic><topic>Double-Blind Method</topic><topic>Drug dosages</topic><topic>Drug therapy</topic><topic>Electrocardiography</topic><topic>Electrocardiography, Ambulatory - drug effects</topic><topic>Female</topic><topic>heart</topic><topic>Humans</topic><topic>hypotension</topic><topic>ischaemia</topic><topic>ischemia</topic><topic>MEDICIN</topic><topic>MEDICINE</topic><topic>Obstetrics and Gynaecology</topic><topic>Obstetrik och gynekologi</topic><topic>Oxytocics - administration & dosage</topic><topic>Oxytocics - adverse effects</topic><topic>oxytocin</topic><topic>Oxytocin - administration & dosage</topic><topic>Oxytocin - adverse effects</topic><topic>Pregnancy</topic><topic>regional anaesthesia</topic><topic>Troponin I - metabolism</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jonsson, M</creatorcontrib><creatorcontrib>Hanson, U</creatorcontrib><creatorcontrib>Lidell, C</creatorcontrib><creatorcontrib>Nordén‐Lindeberg, S</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Uppsala universitet</collection><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jonsson, M</au><au>Hanson, U</au><au>Lidell, C</au><au>Nordén‐Lindeberg, S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>ST depression at caesarean section and the relation to oxytocin dose. A randomised controlled trial</atitle><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle><addtitle>BJOG</addtitle><date>2010-01</date><risdate>2010</risdate><volume>117</volume><issue>1</issue><spage>76</spage><epage>83</epage><pages>76-83</pages><issn>1470-0328</issn><eissn>1471-0528</eissn><coden>BIOGFQ</coden><abstract>Objective To investigate whether there is a difference in occurrence of electrocardiogram changes suggestive of myocardial ischaemia between two different doses of oxytocin.
Design Double‐blind randomised controlled trial
Setting University hospital in Sweden.
Population A total of 103 healthy women undergoing elective caesarean section under spinal anaesthesia.
Methods The participants were randomised to 5 or 10 units of oxytocin, given as an intravenous bolus. A Holter monitor was used to record electrocardiograms and non invasive blood pressure and heart rate (HR) was monitored. A blood sample was obtained 12‐hour postoperatively.
Main outcome measures Depression of the ST segment. Secondary outcomes: symptoms, Troponon I levels, mean arterial pressure (MAP), HR and blood loss.
Results There was a significant difference in occurrence of ST depressions associated with oxytocin administration, 4 (7.7%) with 5 and 11 (21.6%) with 10 units, P < 0.05. The absolute risk reduction was 13.9% (95% confidence interval, 0.5–27.3).
Decrease of mean MAP from baseline to 2 minutes differed, being 9 mmHg in the 5 unit group and 17 mmHg in the 10 unit group (P < 0.01). The increase in mean HR did not differ. Troponin I levels were increased in four subjects (3.9%). There were no differences in occurrence of symptoms, Troponin I levels, or estimated blood loss.
Conclusion ST depressions were associated with oxytocin administration significantly more often in subjects receiving 10 units compared with 5 units. Interventions to prevent hypotension during caesarean section may reduce the occurrence of ST depressions on electrocardiograms.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>19781043</pmid><doi>10.1111/j.1471-0528.2009.02356.x</doi><tpages>8</tpages></addata></record> |
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| subjects | Adult Anesthesia, Obstetrical - methods Anesthesia, Spinal - methods Arrhythmias, Cardiac - blood Arrhythmias, Cardiac - chemically induced Arrhythmias, Cardiac - physiopathology Blood pressure Blood Pressure - drug effects Caesarean section Cesarean Section Clinical trials Dose-Response Relationship, Drug Double-Blind Method Drug dosages Drug therapy Electrocardiography Electrocardiography, Ambulatory - drug effects Female heart Humans hypotension ischaemia ischemia MEDICIN MEDICINE Obstetrics and Gynaecology Obstetrik och gynekologi Oxytocics - administration & dosage Oxytocics - adverse effects oxytocin Oxytocin - administration & dosage Oxytocin - adverse effects Pregnancy regional anaesthesia Troponin I - metabolism |
| title | ST depression at caesarean section and the relation to oxytocin dose. A randomised controlled trial |
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