Effectiveness of Carbetocin Versus Oxytocin Forheamodynamic Satbility After Spinal Anesthesia in C/S Deliveries: A Multicenter Cohort Study in Addis Ababa, Ethiopia
No Thumbnail Available
Date
2025-06-23
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Ababa University
Abstract
Background: Because of its safety margin, spinal anesthetic block is the most commonly used anesthesia procedure for cesarean delivery and during cesarean delivery, uterotonic drugs are routinely recommended after the delivery of the baby to prevent postpartum hemorrhage. Investigations assessing the contractile properties of oxytocin and carbetocin reported comparable adverse reactions for the two agents. Analyzing the hemodynamic side effects of these medicines appears essential and urgent considering their role as prophylactic medication and a rising percentage of high-risk parturient.
Objective: To compare effectiveness of carbetocin versus oxytocin for hemodynamic stability after spinal anesthesia in C/S delivery in a private and tertiary public hospital, a prospective cohort study, Addis Ababa Ethiopia, from February 1- April 30/2025.
Method: A multi-center cohort study had been conducted among 66 parturients who undergone elective cesarean section under spinal anesthesia. The Collected data was statistically analyzed with SPSS version 26. Demographic and clinical data was computed with independent sample t test and categorical data was measured using chi square test and for qualitative variables fisher’s exact test is employed, when applying the condition for chi square test were not fulfilled. Additionally, non-parametric variables were computed using Mann Whitney U test. A P value of< 0.05 was deemed statistically significant.
Result: There was statistically significant difference in terms of hemodynamic parameters1minute after administration of the study medication the decrease in BP was (p- value 0f 0.02inSBP, 0.27 in DBP and 0.003 in MAP). Incidence of hypotension occurred in 12(36.4%) parturients in oxytocin group and 11(33.3%) parturients in a carbetocin group with p- valueof0.796 which is not statistically significant. There was no significant difference in terms of Vasopressor requirement, amount of blood loss and requirement for additional uterotonic agent
among the groups with a p- value of 0.301, 0.285 and 0.286 respectively. Conclusion and recommendation: The change hemodynamic profile was better maintained in the carbetocin group. In the availability of both medications, we recommend to preferably use carbetocin than oxytocin, because of higher incidence of chest pain with the use of oxytocin and better hemodynamic profile in the carbetocin.
Description
Keywords
Oxytocin, Carbetocin, Hemodynamic stability, Spinal anesthesia