• J R Ortiz-Gómez, F Morillas-Ramírez, I Fornet-Ruiz, F J Palacio-Abizanda, and L Bermejo-Albares.
• Hospital Universitario Virgen del Camino, Pamplona, Navarra, España. jortizgo@cfnavarra.es
• Rev Esp Anestesiol Reanim. 2013 Jan 1;60(1):7-15.

ObjectivesTo evaluate uterine contractility, bleeding, haemodynamic performance, and side effects of different doses of oxytocin after delivery under spinal anaesthesia in caesarean section without prior labour in childbirth. We also perform a pharmacoeconomic evaluation.Material And MethodsA randomised, descriptive, observational and multicentre prospective study was conducted, which included 104 ASA 1 patients divided into 3 groups. Group 1 (n=52) received after removal of the foetus and coinciding with foetal umbilical cord clamping, 1 IU of oxytocin followed by an infusion of 2.5 UI×h(-1); Group 2 (n=52) a continuous infusion of 20IU oxytocin at a rate of 700mUI×min(-1) followed later by 10UI×h(-1), and group 3, 100μg bolus dose of carbetocin only.ResultsThere were no statistical differences between groups in anthropometric, obstetric or anaesthetic variables. Significant differences in uterine contraction in vaginal bleeding and the incidence of side effects, particularly headache and tremor, were more pronounced in the carbetocin group.ConclusionsWith these results, we cannot recommend the routine use of carbetocin in caesarean sections, because it is accompanied by an increased incidence of side effects without any improvement in the prevention of obstetric haemorrhage. Finally, it is economically more expensive than the use of low doses of oxytocin, which may be the trend that should be considered in the future, due to the clinical outcomes, and its lower cost.Copyright © 2012 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

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