척추마취하 제왕절개술에서 투여되는 자궁수축제 carbetocin이 산모의 혈역학에 미치는 영향

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 μg was infused over 5 min in 40women undergoing cesarean delivery. Hemodynamic parameters were measured noninvasively using the FinometerⓇ 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 ± 7.9beats/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.