[A case of myocardial ischemia induced by oxytocin during cesarean section]

A 38-year-old pregnant woman underwent cesarean section with combined spinal epidural anesthesia. Immediately after intravenous administration of oxytocin, she developed chest and bilateral shoulder pain. Simultaneously, face flushing and ST segment depression on electrocardiogram were observed. Her blood pressure decreased and heart rate increased. She was treated with bolus injection of phenylephrine and continuous infusion of nicorandil and noradrenaline. At the end of surgery, all the symptoms disappeared. Because oxytocin may induce myocardial ischemia probably due to coronary vasoconstriction and peripheral vasodilation, it is important for anesthesiologists to note that oxytocin should be given to patients as slowly as possible. Alternative agents such as mythylergometrine may be used safely for an individual who is susceptive to oxytocin.