The hemodynamics of oxytocin and other vasoactive agents during neuraxial anesthesia for cesarean delivery: findings in six cases

T. L. Archer, K. Knape, D. Liles, A. S. Wheeler, Bonny C Gillis

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Oxytocin is a commonly used uterotonic that can cause significant and even fatal hypotension, particularly when given as a bolus. The resulting hypotension can be produced by a decrease in systemic vascular resistance or cardiac output through a decrease in venous return. Parturients with normal volume status, heart valves and pulmonary vasculature most often respond to this hypotension with a compensatory increase in heart rate and stroke volume. Oxytocin-induced hypotension at cesarean delivery may be incorrectly attributed to blood loss. Pulse power analysis (also called "pulse contour analysis") of an arterial pressure wave form allows continuous evaluation of systemic vascular resistance and cardiac output in real time, thereby elucidating the causative factors behind changes in blood pressure. Pulse power analysis was conducted in six cases of cesarean delivery performed under neuraxial anesthesia. Hypotension in response to oxytocin was associated with a decrease in systemic vascular resistance and a compensatory increase in stroke volume, heart rate and cardiac output. Pulse power analysis may be helpful in determining the etiology of and treating hypotension during cesarean delivery under neuraxial anesthesia.

Original languageEnglish (US)
Pages (from-to)247-254
Number of pages8
JournalInternational Journal of Obstetric Anesthesia
Volume17
Issue number3
DOIs
StatePublished - Jul 2008

Fingerprint

Oxytocin
Hypotension
Anesthesia
Hemodynamics
Pulse
Cardiac Output
Vascular Resistance
Stroke Volume
Heart Rate
Controlled Hypotension
Cardiac Volume
Heart Valves
Arterial Pressure
Parturition
Blood Pressure
Lung

Keywords

  • Cardiac output
  • Hemodynamics of pregnancy
  • LiDCO
  • Obstetrical hemorrhage
  • Oxytocin
  • Pulse contour analysis
  • Pulse power analysis
  • PulseCO
  • Stroke volume
  • Systemic vascular resistance

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Psychology(all)

Cite this

The hemodynamics of oxytocin and other vasoactive agents during neuraxial anesthesia for cesarean delivery : findings in six cases. / Archer, T. L.; Knape, K.; Liles, D.; Wheeler, A. S.; Gillis, Bonny C.

In: International Journal of Obstetric Anesthesia, Vol. 17, No. 3, 07.2008, p. 247-254.

Research output: Contribution to journalArticle

Archer, T. L. ; Knape, K. ; Liles, D. ; Wheeler, A. S. ; Gillis, Bonny C. / The hemodynamics of oxytocin and other vasoactive agents during neuraxial anesthesia for cesarean delivery : findings in six cases. In: International Journal of Obstetric Anesthesia. 2008 ; Vol. 17, No. 3. pp. 247-254.
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