Efficacy and safety of carbetocin given as an intravenous bolus compared with short infusion for Caesarean section - double-blind, double-dummy, randomized controlled non-inferiority trial

British Journal of Anaesthesia
Salome Dell-KusterThierry Girard

Abstract

Carbetocin is a synthetic oxytocin-analogue, which should be administered as bolus according to manufacturer's recommendations. A higher speed of oxytocin administration leads to increased cardiovascular side-effects. It is unclear whether carbetocin administration as short infusion has the same efficacy on uterine tone compared with bolus administration and whether haemodynamic parameters differ. In this randomized, double-blind, non-inferiority trial, women undergoing planned or unplanned Caesarean section (CS) under regional anaesthesia received a bolus and a short infusion, only one of which contained carbetocin 100 mcg (double dummy). Obstetricians quantified uterine tone two, three, five and 10 min after cord-clamping by manual palpation using a linear analogue scale from 0 to 100. We evaluated whether the lower limit of the 95% CI of the difference in maximum uterine tone within the first five min after cord-clamping did not include the pre-specified non-inferiority limit of -10. Between December 2014 and November 2015, 69 patients were randomized to receive carbetocin as bolus and 71 to receive it as short infusion. Maximal uterine tone was 89 in the bolus and 88 in the short infusion group (mean difference -1.3, 95% CI...Continue Reading

References

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Citations

Apr 26, 2018·The Cochrane Database of Systematic Reviews·Ioannis D GallosArri Coomarasamy
Dec 21, 2018·The Cochrane Database of Systematic Reviews·Ioannis D GallosArri Coomarasamy
May 19, 2020·Hypertension in Pregnancy : Official Journal of the International Society for the Study of Hypertension in Pregnancy·Zakia M IbrahimAmira M Elbahie

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