Alternating nitroglycerin and syntocinon to facilitate uterine exploration and removal of an adherent placenta
| Autor: | Stephen H. Rolbin, Andrew S. H. Chan, Chidambaram Ananthanarayan |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Adult
medicine.medical_specialty Contraction (grammar) Placenta accreta Uterus Blood Pressure Placenta Accreta Myosins Oxytocin Nitroglycerin Uterine Contraction Retained placenta Pregnancy Placenta Internal medicine medicine Humans Phosphorylation Infusions Intravenous Ephedrine business.industry General Medicine medicine.disease Anesthesiology and Pain Medicine medicine.anatomical_structure Endocrinology In utero Anesthesia Calcium Female business Physiological agonism and antagonism Placenta Retained Placenta Diseases |
| Zdroj: | Canadian journal of anaesthesia = Journal canadien d'anesthesie. 42(4) |
| ISSN: | 0832-610X |
| Popis: | Nitroglycerin (NTG) has been demonstrated to provide uterine relaxation in the management of various obstetric complications. A 32-yr-old woman presented 40 min postpartum for manual removal of a retained placenta. Repeated, alternating doses of NTG 250 micrograms and syntocinon (SYN) 10U iv were used over 15 min to produce periods of uterine relaxation and contraction respectively for uterine exploration. Multiple attempts to extract the placenta failed and a diagnosis of placenta accreta was made. There were no major side effects from this combination of drugs apart from a transient 20% decrease in blood pressure after NTG, which responded to ephedrine 10-15 mg iv. The rapid change in uterine tone was believed to be due not only to the short duration of action of NTG and SYN, but also to the possible physiological antagonism between the two drugs. The mechanism of interaction may involve calcium mobilization and myosin light chain phosphorylation. We conclude that NTG and SYN can be used to produce alternating periods of uterine relaxation and contraction rapidly and consistently with little sustained effects from either agents. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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