Preterm labor and delivery constitute major problems in obstetrics. Despite appropriate use of tocolytic therapy, some preterm deliveries are unavoidable and cesarean section is often the mode of delivery. The interactions of beta sympathomimetic tocolytics with anesthetic agents have potential problems for anesthetic management. In this study, our aim was to evaluate the experience of the anesthetic management of cesarean section in patients who received intravenous ritodrine to inhibit preterm labor. Twenty patients, in two groups, between the age of 18 and 35 who had undergone a cesarean section following failure to inhibit preterm labor with intravenous ritodrine therapy as study or control group were studied. Maternal heart rate, blood pressure, serum potassium and glucose levels were evaluated. Mean maternal heart rate in the operating room in ritodrine group was 119+4 bpm, in control group was 84+4 bpm. At the operating theater, mean systolic and diastolic blood pressures of the ritodrine and control groups were 103±7 mmHg, 64±6 mmHg and 118+7 mmHg, 78+4 mmHg, respectively. Serum potassium levels showed a moderate decrease during ritodrine infusion. We consider that central venous pressure (CVP) detection reduces the risk of pulmonary edema and cardiac failure in the course of general anesthesia and recommend that anesthesia be deferred at least 45 minutes following discontinuation of ritodrine in order to minimize the drug interactions with anesthetics.
Key Words: Obstetric anesthesia, ritodrine therapy, preterm labor, tocolysis
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