OBJECTIVE: This study compares the maternal heart rate effects of carbetocin and oxytocin during elective caesarean delivery. DESIGN: Double blind randomised single centre study (1:1). SETTING:University hospital providing intrapartum care. POPULATION: Fifty-six women undergoing elective caesarean section after spinal anaesthesia. METHODS:Haemodynamic parameters were measured non-invasively using the Task Force(®) Monitor 3040i system. Measurements were taken for 500 seconds upon administration of a slow intravenous bolus of the clinically recommended doses of 100 μg of carbetocin or 5 IU of oxytocin to prevent postpartum haemorrhage (PPH). MAIN OUTCOME MEASURE: Effect on maternal heart rate (HR). RESULTS: Statistically indistinguishable haemodynamic effects were seen for both drugs, with a maximal effect at about 30-40 seconds: HR increased 17.98 ± 2.53 bpm for oxytocin and 14.20 ± 2.45 bpm for carbetocin. Systolic blood pressure (sBP) decreased (-26.80 ± 2.82 mmHg for oxytocin versus -22.98 ± 2.75 mmHg for carbetocin). Following the maximal effect, women treated with carbetocin recovered slowly to baseline values asymptotically (HR and BP), whereas women treated with oxytocin displayed a slight rebound bradycardia at 200 seconds (-6.8 ± 1.92 bpm). Patients under both treatments showed a similar profile of side effects without any indication of unexpected adverse effects. CONCLUSION: Both oxytocins have comparable haemodynamic effects and are uterotonic drugs with an acceptable safety profile for prophylactic use. Minimal differences in the recovery phase beyond 70 seconds are in keeping with the fact that carbetocin has an extended half-life compared with oxytocin.
RCT Entities:
OBJECTIVE: This study compares the maternal heart rate effects of carbetocin and oxytocin during elective caesarean delivery. DESIGN: Double blind randomised single centre study (1:1). SETTING: University hospital providing intrapartum care. POPULATION: Fifty-six women undergoing elective caesarean section after spinal anaesthesia. METHODS: Haemodynamic parameters were measured non-invasively using the Task Force(®) Monitor 3040i system. Measurements were taken for 500 seconds upon administration of a slow intravenous bolus of the clinically recommended doses of 100 μg of carbetocin or 5 IU of oxytocin to prevent postpartum haemorrhage (PPH). MAIN OUTCOME MEASURE: Effect on maternal heart rate (HR). RESULTS: Statistically indistinguishable haemodynamic effects were seen for both drugs, with a maximal effect at about 30-40 seconds: HR increased 17.98 ± 2.53 bpm for oxytocin and 14.20 ± 2.45 bpm for carbetocin. Systolic blood pressure (sBP) decreased (-26.80 ± 2.82 mmHg for oxytocin versus -22.98 ± 2.75 mmHg for carbetocin). Following the maximal effect, women treated with carbetocin recovered slowly to baseline values asymptotically (HR and BP), whereas women treated with oxytocin displayed a slight rebound bradycardia at 200 seconds (-6.8 ± 1.92 bpm). Patients under both treatments showed a similar profile of side effects without any indication of unexpected adverse effects. CONCLUSION: Both oxytocins have comparable haemodynamic effects and are uterotonic drugs with an acceptable safety profile for prophylactic use. Minimal differences in the recovery phase beyond 70 seconds are in keeping with the fact that carbetocin has an extended half-life compared with oxytocin.
Authors: D Schlembach; M G Mörtl; T Girard; W Arzt; E Beinder; C Brezinka; K Chalubinski; D Fries; W Gogarten; B-J Hackelöer; H Helmer; W Henrich; I Hösli; P Husslein; F Kainer; U Lang; G Pfanner; W Rath; E Schleussner; H Steiner; D Surbek; R Zimmermann Journal: Anaesthesist Date: 2014-03 Impact factor: 1.041
Authors: Philipp Helmer; Tobias Schlesinger; Sebastian Hottenrott; Michael Papsdorf; Achim Wöckel; Magdalena Sitter; Tobias Skazel; Thomas Wurmb; Ismail Türkmeneli; Christoph Härtel; Stefan Hofer; Ibrahim Alkatout; Leila Messroghli; Thierry Girard; Patrick Meybohm; Peter Kranke Journal: Anaesthesist Date: 2022-03-04 Impact factor: 1.041
Authors: Gisela M Vaitaitis; Michael H Olmstead; Dan M Waid; Jessica R Carter; David H Wagner Journal: Diabetologia Date: 2014-08-08 Impact factor: 10.122
Authors: C A G Holleboom; J van Eyck; S V Koenen; I A M Kreuwel; F Bergwerff; E C Creutzberg; H W Bruinse Journal: Arch Gynecol Obstet Date: 2013-01-18 Impact factor: 2.344
Authors: Ioannis D Gallos; Helen M Williams; Malcolm J Price; Abi Merriel; Harold Gee; David Lissauer; Vidhya Moorthy; Aurelio Tobias; Jonathan J Deeks; Mariana Widmer; Özge Tunçalp; Ahmet Metin Gülmezoglu; G Justus Hofmeyr; Arri Coomarasamy Journal: Cochrane Database Syst Rev Date: 2018-04-25