Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2014.11.015
Brazilian Journal of Anesthesiology
Review Article

Oxytocin in cesarean-sections. What's new?

Ocitocina em cesarianas. O que há de novo?

Eduardo Tsuyoshi Yamaguchi; Mônica Maria Siaulys; Marcelo Luis Abramides Torres

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Abstract

Abstract Oxytocin is the uterotonic agent of choice in the prevention and treatment of postpartum uterine atony. Nevertheless, there is no consensus on the optimal dose and rate for use in cesarean sections. The use of high bolus doses (e.g., 10 IU of oxytocin) can determine deleterious cardiovascular changes for the patient, especially in situations of hypovolemia or low cardiac reserve. Furthermore, high doses of oxytocin for prolonged periods may lead to desensitization of oxytocin receptors in myometrium, resulting in clinical inefficiency.

Keywords

Oxytocin, Cesarean section, Desensitization, Dose

Resumo

Resumo A ocitocina é o uterotônico de primeira escolha na prevenção e no tratamento da atonia uterina após o parto. Apesar disso, não existe consenso sobre qual a dose e velocidade ideais de seu uso em cesarianas. O uso de altas doses (por exemplo, 10 UI de ocitocina) em bolus pode determinar alterações cardiocirculatórias deletérias para a paciente, especialmente em situações de hipovolemia ou baixa reserva cardíaca. Além disso, altas doses de ocitocina por períodos prolongados podem levar à dessensibilização dos receptores de ocitocina localizados no miométrio e resultar em ineficácia clínica.

Palavras-chave

Ocitocina, Cesariana, Dessensibilização, Dose

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