CJA
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text (PDF)
Right arrow Submit a scholarly reply
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Chan, A. S.
Right arrow Articles by Rolbin, S. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Chan, A. S.
Right arrow Articles by Rolbin, S. H.

Canadian Journal of Anesthesia, Vol 42, 335-337, Copyright © 1995 by Canadian Anesthesiologists' Society

ARTICLES

Alternating nitroglycerin and syntocinon to facilitate uterine exploration and removal of an adherent placenta

AS Chan, C Ananthanarayan and SH Rolbin
Department of Anaesthesia, Mount Sinai Hospital, University of Toronto, Ontario.

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.


This article has been cited by other articles:


Home page
 Anesth. Analg.Home page
P. B. Langevin, M. J. Katovich, C. E. Wood, C. F. James, and S. O. Langevin
The Effect of Nitroglycerin on the Gravid Uterus in Sheep and Rabbits
Anesth. Analg., February 1, 2000; 90(2): 337 - 337.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1995 by the Canadian Anesthesiologists' Society.