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Oxytocin at elective caesarean delivery: A dose‐finding study in women with obesity

Anaesthesia Nov 26, 2020

Peska E, Balki M, Maxwell C, et al. - By performing this double‐blind dose‐finding study using the biased coin up‐down design method, researchers intended to establish the bolus dose of oxytocin needed to start effective uterine contraction in 90% of women with obesity (the ED90) at elective caesarean section. Participants were term pregnant women with a BMI ≥ 40 kg.m−2 undergoing elective caesarean delivery under regional anaesthesia. Oxytocin was delivered as an intravenous bolus over 1 minute upon delivery of the fetus. Oxytocin doses were delivered as per a sequential allocation scheme, with the first woman receiving 0.5 IU. By isotonic regression and by the Dixon and Mood method, the ED90 for oxytocin was 0.75 IU and 0.78 IU, respectively. According to the findings, oxytocin needed in women with a BMI ≥ 40 kg.m‐2 was noted to be approximately twice to that required in women with a BMI < 40 kg.m‐2 , in whom an ED90 of 0.35 IU (95%CI 0.15–0.52 IU) has previously been shown.

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