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Table 1 Published studies evaluating doses of oxytocin (syntocinon)

From: Study Protocol. ECSSIT – Elective Caesarean Section Syntocinon® Infusion Trial. A multi-centre randomised controlled trial of oxytocin (Syntocinon®) 5 IU bolus and placebo infusion versus oxytocin 5 IU bolus and 40 IU infusion for the control of blood loss at elective caesarean section

Author, citation Study design Exposures Outcome measures Results Conclusions
Sarna MC et al
Anesth Analg 1997
84:753–6.
RCT
40 women
Elective CS/regional
Oxytocin after cord clamping
5 IU vs 10 IU vs 15 IU vs 20 IU
Linear analogue of uterine tone
EBL
ΔHCT (pre-op/post-op)
No difference in any outcomes No benefit in doses exceeding 5 IU
Zarzur
Anesth Analg 1998
86:1334.
Dose-finding
20 women
Elective CS
Oxytocin dosing Uterine contractility
Side effects
3 IU oxytocin
Satisfactory
No side effects
Low dose 3 IU sufficient
Carvalho JC et al
Obstet Gynecol 2004
104:1005–10.
Dose-finding
RCT single blind
40 women
Elective CS/regional
Titrating increments of 0.5 IU oxytocin bolus
Infusion 2.4 IU/hr
Minimum effective dose ED
Uterine contraction
EBL (calculated)
ED90 at 0.35 IU
100% at 1.0 IU
Low dose bolus < 5 IU effective
Balki M et al
Obstet Gynecol 2006
107:45–50.
Dose-finding
RCT single blind
30 women
CS for labor arrest
Titrating increments of 0.5 IU oxytocin bolus
Infusion 2.4 IU/hr
Minimum effective dose ED
Uterine contraction
EBL (calculated)
ED90 at 3.0 IU Much higher dose than for elective CS
Suggest alternative agent for non-elective