Effects of carbetocin infusion on hemodynamics during cesarean delivery under spinal anesthesia

Kim, Kyoung Ok; Park, Hyun Soo; Yoon, Dong Il; Han, Jin; In, Junyong; Lee, Younsuk

Clinical Research

Obstetric Anesthesia

Anesthesia and Pain Medicine 2013;8(1):51-54.
Published online January 31, 2013.

Effects of carbetocin infusion on hemodynamics during cesarean delivery under spinal anesthesia

Kyoung Ok Kim, Hyun Soo Park, Dong Il Yoon, Jin Han, Junyong In, Younsuk Lee

¹Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Korea. pissces@dumc.or.kr
²Department of Obstetrics and Gynecology, Dongguk University Ilsan Hospital, Goyang, Korea.

Abstract

BACKGROUND
Carbetocin is a long-acting synthetic analogue of oxytocin that is used to prevent postpartum hemorrhage. Cardiovascular effects of oxytocin include tachycardia and hypotension. We investigated hemodynamic changes induced by carbetocin during spinal anesthesia.
METHODS
Carbetocin 100 microg was infused over 5 min in 40 women undergoing cesarean delivery. Hemodynamic parameters were measured noninvasively using the Finometer(R) device. The hemodynamic values were analyzed using multivariate analysis of variance followed by Bonferroni test for multiple comparisons.
RESULTS
Statistically significant hemodynamic effects were seen with a maximal effect at about 75 seconds after infusion start compared with those of baseline: Mean arterial pressure (MAP) decreased 21.6 +/- 8.8 mmHg, systemic vascular resistance (SVR) decreased 28.6 +/- 11.1% and heart rate (HR) increased 15.3 +/- 7.9 beats/min. Following the maximal effect, MAP and SVR remained almost constant at this decreased level until the end of study period. However, HR was slowly recovered after the peak, approaching the baseline value.
CONCLUSIONS
We observed that the maximal hemodynamic changes were occurred at about 75 seconds after administration of carbetocin. Therefore, careful observation is required during this early period.

Key Words: Carbetocin, Cardiovascular effects, Cesarean delivery, Postpartum hemorrhage