Compare Hemodynamic Effect of Oxytocin Bolus and Infusion During Cesarean Section Under Spinal Anesthesia

STUDY OF EFFECT OF HEMODYNAMIC CHANGES CAUSED BY OXYTOCIN DURING CESAREAN SECTION UNDER SPINAL ANESTHESIA: COMPARISON BETWEEN INTRAVENOUS BOLUS AND INFUSION TECHNIQUE

Oxytocin is routinely used during a cesarean section to promote uterine contraction and prevent postpartum hemorrhage. It is typically administered immediately after delivery of the baby, either as a slow intravenous bolus followed by a continuous infusion or as an infusion alone, depending on clinical protocols. By stimulating the uterine muscles to contract, oxytocin helps reduce blood loss and facilitates uterine involution. Care is taken to avoid rapid high-dose administration, as this may lead to side effects such as hypotension and tachycardia

The administration of Oxytocin during cesarean section under Spinal anesthesia is associated with significant hemodynamic changes, and these effects differ depending on whether the drug is given as an intravenous bolus or as a controlled infusion. Oxytocin causes vasodilation and decreases systemic vascular resistance, which can lead to hypotension, reflex tachycardia, and occasionally nausea or flushing-effects that are often exaggerated under spinal anesthesia due to pre-existing sympathetic blockade. When given as a rapid IV bolus (e.g., 5-10 IU), there is a sudden drop in blood pressure and a marked increase in heart rate, sometimes accompanied by transient myocardial ischemia in susceptible patients. In contrast, administering oxytocin as a slow infusion (e.g., 10-40 IU diluted in IV fluids over time) results in more gradual hemodynamic changes, with better stability of blood pressure and heart rate. Comparative studies have consistently shown that infusion regimens are associated with fewer adverse cardiovascular effects while still providing adequate uterine contraction. Therefore, current clinical practice favors low-dose slow bolus followed by infusion, or infusion alone, to minimize hemodynamic instability while effectively preventing postpartum hemorrhage.

Inclusion Criteria:

Women within age range 18-40 Years Women undergoing caesarian with oxytocin under spinal anesthesia as defined in the operational definition.

Exclusion Criteria Women with placenta praevia Women with ruptured membranes Women with hypertensive disorders or diabetes mellitus Women on immunosuppressant