Comparison of Carbetocin as a Bolus or Infusion With Prophylactic Phenylephrine on Maternal Heart Rate During Cesarean Delivery Under Spinal Anesthesia: A Double-Blinded Randomized Controlled Trial

Abstract

(Can J Anesth/J Can Anesth. 2022:69:715–725) Carbetocin is used in elective cesarean deliveries to reduce the risk of postpartum hemorrhage, and the current practice is to administer the drug as a bolus injection. Side effects of carbetocin include low blood pressure and elevated or irregular heart rate. For some patients, this may lead to hemodynamic alterations and raises the question of potential benefits to heart rate and other hemodynamic factors by administering carbetocin via a 10-minute infusion. This study compared a bolus injection to a 10-minute infusion, both with a prophylactic infusion of phenylephrine, to understand if there are significant and clinically applicable differences in heart rate. This study primarily examined variation in heart rate within 20 minutes of drug administration, but also examined other hemodynamic factors such as blood pressure and stroke volume.