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[Time course of thoracic epidural pressure and saphenous venous pressure changes with oxytocics after fetus delivery in parturients undergoing cesarean section].

BACKGROUND: We examined the effects of oxytotics administered after fetus delivery on epidural and venous pressures in 40 parturients undergoing cesarean section under spinal anesthesia. METHODS: The subjects received 0.5% isobaric bupivacaine for spinal anesthesia. An epidural catheter placed at T11-12 and a venous catheter placed at left saphenous vein, were connected to pressure transducers to monitor each pressure. The subjects received intravenous methylergometrine 0.2 mg (methylergometrine group: n=20) or oxytocin 10 IU (oxytocin group: n=20) immediately after fetus delivery. Intramyometrial PGF2alpha was additionally administered from 5 minutes after fetus delivery in case of low uterine tone. Statistic analysis was performed with ANOVA. RESULTS: Epidural pressure in the methylergometrine group increased at placental delivery and the increase continued until 15 minutes after delivery (P<0.05). Epidural pressure in the oxytocin group increased at placental delivery and began to decrease at 5 minutes after delivery (P<0.05). Saphenous venous pressure began to increase at 10 minutes after delivery in the methylergometrine group (P<0.05). CONCLUSIONS: The increase in epidural pressure within 5 minutes after fetus delivery would be caused by uterine contraction in both groups. The vasoconstrictive effect in the methylergometrine group is likely to cause the epidural pressure increase after delivery.

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