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SAFETY OF UTEROTONICS: WHAT ANAESTHESIOLOGIST SHOULD KNOW ABOUT THEM?


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Abstract

The most important aspect of the prevention and treatment of postpartum hemorrhage is the use of uterotonics. The review focused attention on the proper use of oxytocin. The analysis of literature, Scopus databases, Web of Science, MedLine, The Cochrane Library, EMBASE, Global Health, CyberLeninka, RISC, used materials leading organizations: World Health Organization, American Academy of Family Physicians, Royal College of Obstetricians and Gynaecologists (RCOG), International Federation of Obstetrics and Gynecology (FIGO), Collège National des Gynécologues et Obstétriciens Français, American College of Obstetricians and Gynecologists (ACOG), Cochrane Reviews has shown that oxytocin remains the drug of first-line, both for prevention and treatment of postpartum uterine bleeding. When a planned Caesarean section 5 IU oxytocin use as a standard dose is excessive and requires re-evaluation. Adequate uterine contractions can occur with lower doses of oxytocin (0,5-3 units). A slow bolus administration of oxytocin can effectively minimize the cardiovascular side effects without compromising the therapeutic effect. Since the side effects of oxytocin dose dependent, is expedient oxytocin administered as a slow infusion. If hypotension uterus, if there is no adequate response to initial treatment with oxytocin, attention should be paid to the use of second-line uterotonic. In hemodynamically unstable patients should be using oxytocin is necessary to exercise the utmost restraint. We believe that further work is needed on the study and implementation of security schemes intraoperative use of uterotonics.


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