Effects of Preoperative Sublingual Misoprostol on Uterine Tone during Isoflurane Anesthesia for Cesarean Section
Misoprostol would reduce the uterine bleeding after cesarean delivery without harmful effects on either mother or baby. We aimed to evaluate the effects of preoperative misoprostol on maternal blood loss, uterine tone, and the need for additional oxytocin after cesarean delivery under isoflurane ane...
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| Veröffentlicht in: | Revista brasileira de anestesiologia 2012-09, Vol.62 (5), p.625-635 |
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| description | Misoprostol would reduce the uterine bleeding after cesarean delivery without harmful effects on either mother or baby. We aimed to evaluate the effects of preoperative misoprostol on maternal blood loss, uterine tone, and the need for additional oxytocin after cesarean delivery under isoflurane anesthesia.
After ethical approval, 366 patients scheduled for elective cesarean delivery were randomly allocated to receive either sublingual misoprostol 400μg (n=179) or placebo tablet (n=187) after intubation. Anesthesia was maintained with 0.5–0.7 MAC isoflurane with nitrous oxide. All patients received intravenous infusion of 10IU of oxytocin after placental delivery. Perioperative estimated blood loss, uterine tone, need for supplementary oxytocin, hematocrit, Apgar scores at 1 and 5 min and adverse effects were recorded.
After induction, patients receiving sublingual misoprostol had significant less perioperative estimated blood loss (202±383.1 vs. 708±204.3mL, p |
| doi_str_mv | 10.1016/S0034-7094(12)70162-9 |
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After ethical approval, 366 patients scheduled for elective cesarean delivery were randomly allocated to receive either sublingual misoprostol 400μg (n=179) or placebo tablet (n=187) after intubation. Anesthesia was maintained with 0.5–0.7 MAC isoflurane with nitrous oxide. All patients received intravenous infusion of 10IU of oxytocin after placental delivery. Perioperative estimated blood loss, uterine tone, need for supplementary oxytocin, hematocrit, Apgar scores at 1 and 5 min and adverse effects were recorded.
After induction, patients receiving sublingual misoprostol had significant less perioperative estimated blood loss (202±383.1 vs. 708±204.3mL, p<0.001), need for oxytocin (p<0.001), higher hematocrit levels (p<0.001) and uterine tone (p<0.02). The incidence of shivering was higher in the misoprostol group (p=0.04). There were no differences between the two groups as regarding Apgar scores, nausea and vomiting, gastrointestinal disturbances and pyrexia.
Preoperative administration of sublingual misoprostol 400μg is safe and effective in attenuating the maternal bleeding and uterine atony from isoflurane anesthesia for cesarean delivery.
Misoprostol reduz o sangramento uterino após o parto cesáreo sem efeitos prejudiciais para a mãe ou o bebê. Nosso objetivo foi avaliar os efeitos de misoprostol pré-operatório no sangramento materno e no tônus uterino e a necessidade de ocitocina após cesariana sob anestesia com isoflurano.
Depois da aprovação pelo Comitê de Ética, 366 pacientes programadas para cesariana eletiva foram randomicamente designadas para receber 400μg de misoprostol sublingual (n=179) ou um comprimido de placebo (n=187) após intubação. A anestesia foi mantida com CAM de isoflurano a 0,5–0,7 e óxido nitroso. Todas as pacientes receberam infusão de ocitocina (10UI) após expulsão da placenta. A estimativa de perda sanguínea, do tônus uterino, da necessidade de ocitocina complementar, da contagem de hematócrito, dos escores de Apgar no 1° e aos 5 minutos e os efeitos adversos foram registrados.
Após a indução, as pacientes que receberam misoprostol sublingual tiveram perda sanguínea perioperatória (202±383,1 vs 708±204,3mL, p<0,001), necessidade de ocitocina (p<0,001), níveis mais elevados de hematócrito (p<0,001) e tônus uterino (p<0,02) menos significativos. A incidência de tremores foi maior no grupo misoprostol (p=0,04). Não houve diferenças entre os dois grupos quanto aos índices de Apgar, náusea e vômito, distúrbios gastrointestinais e febre.
A administração pré-operatória de misoprostol sublingual (400μg) é segura e eficaz para atenuar o sangramento materno e o efeito no tônus uterino da anestesia com isoflurano em parto cesário.
El Misoprostol reduce el sangramiento uterino después del parto por cesárea sin efectos perjudiciales para la madre o el bebé. Nuestro objetivo fue evaluar los efectos del misoprostol preoperatorio en el sangramiento materno y en el tono uterino, y la necesidad de ocitocina después de la cesárea bajo anestesia con isoflurano.
Después de la aprobación por el Comité de Ética, 366 pacientes programadas para la cesárea electiva, fueron randómicamente designadas para recibir 400μg de misoprostol sublingual (n=179) o un comprimido de placebo (n=187) después de la intubación. La anestesia se mantuvo con CAM de isoflurano a 0,5–0,7 y óxido nitroso. Todas las pacientes recibieron una infusión de ocitocina (10 UI) después de la expulsión de la placenta. La estimación de la pérdida sanguínea, del tono uterino, de la necesidad de ocitocina complementaria, del conteo de hematocrito, de los puntajes de Apgar en el 1° y a los 5 minutos y los efectos adversos fueron todos registrados.
Después de la inducción, las pacientes que recibieron misoprostol sublingual tuvieron una pérdida sanguínea perioperatoria (202±383,1 vs 708±204,3mL, p<0,001), necesidad de ocitocina (p<0,001), niveles más elevados de hematocrito (p<0,001) y tono uterino (p<0,02) menos significativos. La incidencia de temblores fue mayor en el grupo misoprostol (p=0,04). No se registraron diferencias entre los dos grupos en cuanto a los índices de Apgar, náusea y vómito, trastornos gastrointestinales y fiebre.
La administración preoperatoria de misoprostol sublingual (400μg) es segura y eficaz para atenuar el sangramiento materno y el efecto en el tono uterino de la anestesia con isoflurano en el parto por cesárea.]]></description><identifier>ISSN: 0034-7094</identifier><identifier>EISSN: 1806-907X</identifier><identifier>DOI: 10.1016/S0034-7094(12)70162-9</identifier><identifier>PMID: 22999396</identifier><language>eng</language><publisher>Brazil: Elsevier Editora Ltda</publisher><subject>Administration, Sublingual ; Adolescent ; Adult ; ANESTESIA, Obstétrica ; Anesthesia, Obstetrical ; Anesthetics, Inhalation - therapeutic use ; ANESTÉSICOS, Volatil, isoflurano ; Cesarean Section ; CIRUGÍA, Cesárea ; CIRURGIA, Cesárea ; COMPLICACIONES, Sangramiento ; COMPLICAÇÕES, Hemorragia ; Double-Blind Method ; DROGAS, misoprostol ; Female ; Hemorrhage ; Humans ; Isoflurane ; Isoflurane - therapeutic use ; Misoprostol ; Misoprostol - administration & dosage ; Oxytocics - administration & dosage ; Pregnancy ; Preoperative Care ; Uterus - drug effects ; Young Adult</subject><ispartof>Revista brasileira de anestesiologia, 2012-09, Vol.62 (5), p.625-635</ispartof><rights>2012 Elsevier Editora Ltda.</rights><rights>Copyright © 2012 Elsevier Editora Ltda. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c412t-c0b49a34a1778ef18c61fa61a7f76000bacadd2c746be9983a3d1b0cfa09eaff3</citedby><cites>FETCH-LOGICAL-c412t-c0b49a34a1778ef18c61fa61a7f76000bacadd2c746be9983a3d1b0cfa09eaff3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0034-7094(12)70162-9$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,864,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22999396$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>El Tahan, Mohamed R.</creatorcontrib><creatorcontrib>Warda, Osama M.</creatorcontrib><creatorcontrib>Rashad, Amal</creatorcontrib><creatorcontrib>Yasseen, Amr M.</creatorcontrib><creatorcontrib>Ramzy, Eiad A.</creatorcontrib><creatorcontrib>Ahmady, Mona S.</creatorcontrib><creatorcontrib>Diab, Douaa G.</creatorcontrib><creatorcontrib>Matter, Mohamed K.</creatorcontrib><title>Effects of Preoperative Sublingual Misoprostol on Uterine Tone during Isoflurane Anesthesia for Cesarean Section</title><title>Revista brasileira de anestesiologia</title><addtitle>Rev Bras Anestesiol</addtitle><description><![CDATA[Misoprostol would reduce the uterine bleeding after cesarean delivery without harmful effects on either mother or baby. We aimed to evaluate the effects of preoperative misoprostol on maternal blood loss, uterine tone, and the need for additional oxytocin after cesarean delivery under isoflurane anesthesia.
After ethical approval, 366 patients scheduled for elective cesarean delivery were randomly allocated to receive either sublingual misoprostol 400μg (n=179) or placebo tablet (n=187) after intubation. Anesthesia was maintained with 0.5–0.7 MAC isoflurane with nitrous oxide. All patients received intravenous infusion of 10IU of oxytocin after placental delivery. Perioperative estimated blood loss, uterine tone, need for supplementary oxytocin, hematocrit, Apgar scores at 1 and 5 min and adverse effects were recorded.
After induction, patients receiving sublingual misoprostol had significant less perioperative estimated blood loss (202±383.1 vs. 708±204.3mL, p<0.001), need for oxytocin (p<0.001), higher hematocrit levels (p<0.001) and uterine tone (p<0.02). The incidence of shivering was higher in the misoprostol group (p=0.04). There were no differences between the two groups as regarding Apgar scores, nausea and vomiting, gastrointestinal disturbances and pyrexia.
Preoperative administration of sublingual misoprostol 400μg is safe and effective in attenuating the maternal bleeding and uterine atony from isoflurane anesthesia for cesarean delivery.
Misoprostol reduz o sangramento uterino após o parto cesáreo sem efeitos prejudiciais para a mãe ou o bebê. Nosso objetivo foi avaliar os efeitos de misoprostol pré-operatório no sangramento materno e no tônus uterino e a necessidade de ocitocina após cesariana sob anestesia com isoflurano.
Depois da aprovação pelo Comitê de Ética, 366 pacientes programadas para cesariana eletiva foram randomicamente designadas para receber 400μg de misoprostol sublingual (n=179) ou um comprimido de placebo (n=187) após intubação. A anestesia foi mantida com CAM de isoflurano a 0,5–0,7 e óxido nitroso. Todas as pacientes receberam infusão de ocitocina (10UI) após expulsão da placenta. A estimativa de perda sanguínea, do tônus uterino, da necessidade de ocitocina complementar, da contagem de hematócrito, dos escores de Apgar no 1° e aos 5 minutos e os efeitos adversos foram registrados.
Após a indução, as pacientes que receberam misoprostol sublingual tiveram perda sanguínea perioperatória (202±383,1 vs 708±204,3mL, p<0,001), necessidade de ocitocina (p<0,001), níveis mais elevados de hematócrito (p<0,001) e tônus uterino (p<0,02) menos significativos. A incidência de tremores foi maior no grupo misoprostol (p=0,04). Não houve diferenças entre os dois grupos quanto aos índices de Apgar, náusea e vômito, distúrbios gastrointestinais e febre.
A administração pré-operatória de misoprostol sublingual (400μg) é segura e eficaz para atenuar o sangramento materno e o efeito no tônus uterino da anestesia com isoflurano em parto cesário.
El Misoprostol reduce el sangramiento uterino después del parto por cesárea sin efectos perjudiciales para la madre o el bebé. Nuestro objetivo fue evaluar los efectos del misoprostol preoperatorio en el sangramiento materno y en el tono uterino, y la necesidad de ocitocina después de la cesárea bajo anestesia con isoflurano.
Después de la aprobación por el Comité de Ética, 366 pacientes programadas para la cesárea electiva, fueron randómicamente designadas para recibir 400μg de misoprostol sublingual (n=179) o un comprimido de placebo (n=187) después de la intubación. La anestesia se mantuvo con CAM de isoflurano a 0,5–0,7 y óxido nitroso. Todas las pacientes recibieron una infusión de ocitocina (10 UI) después de la expulsión de la placenta. La estimación de la pérdida sanguínea, del tono uterino, de la necesidad de ocitocina complementaria, del conteo de hematocrito, de los puntajes de Apgar en el 1° y a los 5 minutos y los efectos adversos fueron todos registrados.
Después de la inducción, las pacientes que recibieron misoprostol sublingual tuvieron una pérdida sanguínea perioperatoria (202±383,1 vs 708±204,3mL, p<0,001), necesidad de ocitocina (p<0,001), niveles más elevados de hematocrito (p<0,001) y tono uterino (p<0,02) menos significativos. La incidencia de temblores fue mayor en el grupo misoprostol (p=0,04). No se registraron diferencias entre los dos grupos en cuanto a los índices de Apgar, náusea y vómito, trastornos gastrointestinales y fiebre.
La administración preoperatoria de misoprostol sublingual (400μg) es segura y eficaz para atenuar el sangramiento materno y el efecto en el tono uterino de la anestesia con isoflurano en el parto por cesárea.]]></description><subject>Administration, Sublingual</subject><subject>Adolescent</subject><subject>Adult</subject><subject>ANESTESIA, Obstétrica</subject><subject>Anesthesia, Obstetrical</subject><subject>Anesthetics, Inhalation - therapeutic use</subject><subject>ANESTÉSICOS, Volatil, isoflurano</subject><subject>Cesarean Section</subject><subject>CIRUGÍA, Cesárea</subject><subject>CIRURGIA, Cesárea</subject><subject>COMPLICACIONES, Sangramiento</subject><subject>COMPLICAÇÕES, Hemorragia</subject><subject>Double-Blind Method</subject><subject>DROGAS, misoprostol</subject><subject>Female</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Isoflurane</subject><subject>Isoflurane - therapeutic use</subject><subject>Misoprostol</subject><subject>Misoprostol - administration & dosage</subject><subject>Oxytocics - administration & dosage</subject><subject>Pregnancy</subject><subject>Preoperative Care</subject><subject>Uterus - drug effects</subject><subject>Young Adult</subject><issn>0034-7094</issn><issn>1806-907X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMFO3DAQhi3UqrtAH4HKRzikHTvZOD5VaEULEgikZSVu1sQZb11l462dIPXtMeyWay-2NfrG_8zH2JmArwJE_W0FUFaFAl2dC3mhckkW-ojNRQN1oUE9fWDzd2TGjlP6DSDrhYBPbCal1rrU9ZztrpwjOyYeHH-IFHYUcfTPxFdT2_thM2HP73wKuxjSGHoeBr4eKfqB-GPIRzfl94bfpOD6KWKuXA6Uxl-UPHIXIl9Swkg48FWO8WE4ZR8d9ok-H-4Ttv5x9bi8Lm7vf94sL28LWwk5FhbaSmNZoVCqIScaWwuHtUDlVA0ALVrsOmlVVbekdVNi2YkWrEPQhM6VJ-x8_2-e_M-URzJbnyz1fZ4xTMkIUJVqylIuMrrYozYvmSI5s4t-i_FvhsyrbPMm27yaNEKaN9lG574vh4ip3VL33vXPbga-7wHKiz57iiZZT4Olzsdsw3TB_yfiBYj_kUg</recordid><startdate>201209</startdate><enddate>201209</enddate><creator>El Tahan, Mohamed R.</creator><creator>Warda, Osama M.</creator><creator>Rashad, Amal</creator><creator>Yasseen, Amr M.</creator><creator>Ramzy, Eiad A.</creator><creator>Ahmady, Mona S.</creator><creator>Diab, Douaa G.</creator><creator>Matter, Mohamed K.</creator><general>Elsevier Editora Ltda</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201209</creationdate><title>Effects of Preoperative Sublingual Misoprostol on Uterine Tone during Isoflurane Anesthesia for Cesarean Section</title><author>El Tahan, Mohamed R. ; Warda, Osama M. ; Rashad, Amal ; Yasseen, Amr M. ; Ramzy, Eiad A. ; Ahmady, Mona S. ; Diab, Douaa G. ; Matter, Mohamed K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c412t-c0b49a34a1778ef18c61fa61a7f76000bacadd2c746be9983a3d1b0cfa09eaff3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Administration, Sublingual</topic><topic>Adolescent</topic><topic>Adult</topic><topic>ANESTESIA, Obstétrica</topic><topic>Anesthesia, Obstetrical</topic><topic>Anesthetics, Inhalation - therapeutic use</topic><topic>ANESTÉSICOS, Volatil, isoflurano</topic><topic>Cesarean Section</topic><topic>CIRUGÍA, Cesárea</topic><topic>CIRURGIA, Cesárea</topic><topic>COMPLICACIONES, Sangramiento</topic><topic>COMPLICAÇÕES, Hemorragia</topic><topic>Double-Blind Method</topic><topic>DROGAS, misoprostol</topic><topic>Female</topic><topic>Hemorrhage</topic><topic>Humans</topic><topic>Isoflurane</topic><topic>Isoflurane - therapeutic use</topic><topic>Misoprostol</topic><topic>Misoprostol - administration & dosage</topic><topic>Oxytocics - administration & dosage</topic><topic>Pregnancy</topic><topic>Preoperative Care</topic><topic>Uterus - drug effects</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>El Tahan, Mohamed R.</creatorcontrib><creatorcontrib>Warda, Osama M.</creatorcontrib><creatorcontrib>Rashad, Amal</creatorcontrib><creatorcontrib>Yasseen, Amr M.</creatorcontrib><creatorcontrib>Ramzy, Eiad A.</creatorcontrib><creatorcontrib>Ahmady, Mona S.</creatorcontrib><creatorcontrib>Diab, Douaa G.</creatorcontrib><creatorcontrib>Matter, Mohamed K.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Revista brasileira de anestesiologia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>El Tahan, Mohamed R.</au><au>Warda, Osama M.</au><au>Rashad, Amal</au><au>Yasseen, Amr M.</au><au>Ramzy, Eiad A.</au><au>Ahmady, Mona S.</au><au>Diab, Douaa G.</au><au>Matter, Mohamed K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of Preoperative Sublingual Misoprostol on Uterine Tone during Isoflurane Anesthesia for Cesarean Section</atitle><jtitle>Revista brasileira de anestesiologia</jtitle><addtitle>Rev Bras Anestesiol</addtitle><date>2012-09</date><risdate>2012</risdate><volume>62</volume><issue>5</issue><spage>625</spage><epage>635</epage><pages>625-635</pages><issn>0034-7094</issn><eissn>1806-907X</eissn><abstract><![CDATA[Misoprostol would reduce the uterine bleeding after cesarean delivery without harmful effects on either mother or baby. We aimed to evaluate the effects of preoperative misoprostol on maternal blood loss, uterine tone, and the need for additional oxytocin after cesarean delivery under isoflurane anesthesia.
After ethical approval, 366 patients scheduled for elective cesarean delivery were randomly allocated to receive either sublingual misoprostol 400μg (n=179) or placebo tablet (n=187) after intubation. Anesthesia was maintained with 0.5–0.7 MAC isoflurane with nitrous oxide. All patients received intravenous infusion of 10IU of oxytocin after placental delivery. Perioperative estimated blood loss, uterine tone, need for supplementary oxytocin, hematocrit, Apgar scores at 1 and 5 min and adverse effects were recorded.
After induction, patients receiving sublingual misoprostol had significant less perioperative estimated blood loss (202±383.1 vs. 708±204.3mL, p<0.001), need for oxytocin (p<0.001), higher hematocrit levels (p<0.001) and uterine tone (p<0.02). The incidence of shivering was higher in the misoprostol group (p=0.04). There were no differences between the two groups as regarding Apgar scores, nausea and vomiting, gastrointestinal disturbances and pyrexia.
Preoperative administration of sublingual misoprostol 400μg is safe and effective in attenuating the maternal bleeding and uterine atony from isoflurane anesthesia for cesarean delivery.
Misoprostol reduz o sangramento uterino após o parto cesáreo sem efeitos prejudiciais para a mãe ou o bebê. Nosso objetivo foi avaliar os efeitos de misoprostol pré-operatório no sangramento materno e no tônus uterino e a necessidade de ocitocina após cesariana sob anestesia com isoflurano.
Depois da aprovação pelo Comitê de Ética, 366 pacientes programadas para cesariana eletiva foram randomicamente designadas para receber 400μg de misoprostol sublingual (n=179) ou um comprimido de placebo (n=187) após intubação. A anestesia foi mantida com CAM de isoflurano a 0,5–0,7 e óxido nitroso. Todas as pacientes receberam infusão de ocitocina (10UI) após expulsão da placenta. A estimativa de perda sanguínea, do tônus uterino, da necessidade de ocitocina complementar, da contagem de hematócrito, dos escores de Apgar no 1° e aos 5 minutos e os efeitos adversos foram registrados.
Após a indução, as pacientes que receberam misoprostol sublingual tiveram perda sanguínea perioperatória (202±383,1 vs 708±204,3mL, p<0,001), necessidade de ocitocina (p<0,001), níveis mais elevados de hematócrito (p<0,001) e tônus uterino (p<0,02) menos significativos. A incidência de tremores foi maior no grupo misoprostol (p=0,04). Não houve diferenças entre os dois grupos quanto aos índices de Apgar, náusea e vômito, distúrbios gastrointestinais e febre.
A administração pré-operatória de misoprostol sublingual (400μg) é segura e eficaz para atenuar o sangramento materno e o efeito no tônus uterino da anestesia com isoflurano em parto cesário.
El Misoprostol reduce el sangramiento uterino después del parto por cesárea sin efectos perjudiciales para la madre o el bebé. Nuestro objetivo fue evaluar los efectos del misoprostol preoperatorio en el sangramiento materno y en el tono uterino, y la necesidad de ocitocina después de la cesárea bajo anestesia con isoflurano.
Después de la aprobación por el Comité de Ética, 366 pacientes programadas para la cesárea electiva, fueron randómicamente designadas para recibir 400μg de misoprostol sublingual (n=179) o un comprimido de placebo (n=187) después de la intubación. La anestesia se mantuvo con CAM de isoflurano a 0,5–0,7 y óxido nitroso. Todas las pacientes recibieron una infusión de ocitocina (10 UI) después de la expulsión de la placenta. La estimación de la pérdida sanguínea, del tono uterino, de la necesidad de ocitocina complementaria, del conteo de hematocrito, de los puntajes de Apgar en el 1° y a los 5 minutos y los efectos adversos fueron todos registrados.
Después de la inducción, las pacientes que recibieron misoprostol sublingual tuvieron una pérdida sanguínea perioperatoria (202±383,1 vs 708±204,3mL, p<0,001), necesidad de ocitocina (p<0,001), niveles más elevados de hematocrito (p<0,001) y tono uterino (p<0,02) menos significativos. La incidencia de temblores fue mayor en el grupo misoprostol (p=0,04). No se registraron diferencias entre los dos grupos en cuanto a los índices de Apgar, náusea y vómito, trastornos gastrointestinales y fiebre.
La administración preoperatoria de misoprostol sublingual (400μg) es segura y eficaz para atenuar el sangramiento materno y el efecto en el tono uterino de la anestesia con isoflurano en el parto por cesárea.]]></abstract><cop>Brazil</cop><pub>Elsevier Editora Ltda</pub><pmid>22999396</pmid><doi>10.1016/S0034-7094(12)70162-9</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0034-7094 |
| ispartof | Revista brasileira de anestesiologia, 2012-09, Vol.62 (5), p.625-635 |
| issn | 0034-7094 1806-907X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1074783325 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Access via ScienceDirect (Elsevier); EZB Electronic Journals Library |
| subjects | Administration, Sublingual Adolescent Adult ANESTESIA, Obstétrica Anesthesia, Obstetrical Anesthetics, Inhalation - therapeutic use ANESTÉSICOS, Volatil, isoflurano Cesarean Section CIRUGÍA, Cesárea CIRURGIA, Cesárea COMPLICACIONES, Sangramiento COMPLICAÇÕES, Hemorragia Double-Blind Method DROGAS, misoprostol Female Hemorrhage Humans Isoflurane Isoflurane - therapeutic use Misoprostol Misoprostol - administration & dosage Oxytocics - administration & dosage Pregnancy Preoperative Care Uterus - drug effects Young Adult |
| title | Effects of Preoperative Sublingual Misoprostol on Uterine Tone during Isoflurane Anesthesia for Cesarean Section |
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