A Review of the Existing Evidence-based Protocols/guidelines on Oxytocin Dosing during Elective Cesarean Section to Prevent Post-partum Hemorrhage--A Creation of a Class A Pharmacology Continuing Educational Module for Certified Registered Nurse Anesthetist

Abstract

Oxytocin is an endogenous hormone, and Pitocin is its synthetic analog often administered in the parturient patient to induce labor and further dilate the cervix. Per the American College of Obstetricians and Gynecologists (ACOG) and American Society of Anesthesiologists (ASA), there are standard dosage and administration guidelines to ensure safe delivery and decrease postpartum hemorrhage (PPH) (2020). Anesthesia providers must understand these administration guidelines to ensure more favorable health outcomes in the laboring woman. Globally, PPH is the leading cause of maternal mortality. A literature review suggests Pitocin via intravenous administration during active labor can significantly reduce postpartum hemorrhage, thus leading to more favorable health outcomes in the parturient patient (Salati et al., 2019). Education is a method of affecting change. A 60-minute evidenced-based Class A pharmacology continuing education (CE) module on the appropriate use of Pitocin to prevent PPH during elective cesarean section was developed for Certified Registered Nurse Anesthetists (CRNAs) and Student Registered Nurse Anesthetists (SRNAs). The goal of the module is to discuss the role of oxytocin in the parturient patient, to provide evidence-based recommendations for intravenous Pitocin dosing during elective cesarean section to prevent PPH, and to understand the physiological changes associated with increased levels of oxytocin.

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Keywords

Postpartum Hemorrhage, Cesarean Section, Oxytocin, Dosage, Educational Module

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