Dose-finding study evaluates the effective dosage of oxytocin in elective cesarean deliveries, suggesting lower needs post-bolus.
( Can J Anesth . 2024;71:1363–1371. DOI: 10.1007/s12630-024-02828-9) Postpartum hemorrhage (PPH) is a major cause of maternal death, and oxytocin is recommended after placenta delivery to reduce PPH risk by up to 40%. It is given as an intravenous bolus followed by a maintenance infusion (OMI) to sustain uterine tone. Current guidelines suggest an initial 1 IU bolus, followed by an OMI of 2.5 to 7.5 IU/h. Previous studies in elective cesarean deliveries (CDs) found the minimum effective dose (ED90) without an initial bolus to be 16.2 to 17.4 IU/h. Given the variability in dosing strategies and limited evidence on oxytocin regimens after a bolus, this study aimed to determine the ED90 of OMI after an initial bolus, hypothesizing that the required dose would be lower.
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Boonstra et al. (2025) studied this question.
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