Carbetocin Compared With Oxytocin in Nonelective Cesarean Delivery: A Systematic Review, Meta-analysis, and Trial Sequential Analysis of Randomized-controlled Trials

Abstract

(Can J Anesth. 2020;67:1524–1534) Uterotonic agents, such as oxytocin and carbetocin, are used in the management of uterine atony, a major cause of postpartum hemorrhage (PPH). While oxytocin and carbetocin both have fast onset of action, oxytocin has a short duration of action, requiring immediate intravenous (IV) infusion during the perioperative period. In contrast, carbetocin has a longer duration with effects lasting for 60 minutes after onset. Previous literature suggests that carbetocin may be as effective as oxytocin, and a recent study showed that the need for additional uterotonics was reduced by 53% with carbetocin versus oxytocin for elective cesarean delivery (CD). However, it remains unclear how these 2 uterotonics compare in pregnant women undergoing nonelective CD. The aim of this study was to compare the efficacy of carbetocin with oxytocin in women undergoing nonelective CD.