Comparing the Efficacy of Various Anaesthesia Protocols for Caesarean Section in Dogs

Abstract

Introduction. Caesarean section is attributed with frequent deaths among newborn puppies – up to 30%, depending on the chosen anaesthetic care and the presence of aggravating factors. The right choice of drugs and anaesthetic techniques can significantly affect the clinical outcomes. Because a standardised anaesthesia protocol for the caesarean section in dogs is missing in Russia, the research in this area is very relevant. The aim of the work is to compare three variants of the anaesthesia protocols across the basic clinical outcomes of a caesarean section delivery in a dog (including intra- and postoperative results, mortality rate) and to determine the most efficient and safe one for a bitch and puppies.Materials and Methods. The research was conducted at the premises of Rostov-on-Don veterinary clinic in the period from December 2021 to December 2023. There were selected 63 pregnant bitches who met the inclusion and exclusion criteria at that period of time. The animals were divided into three groups: in the first group the anaesthetic care included induction with propofol, intraoperative inhalation anaesthesia with sevoflurane and epidural lidocaine anaesthesia; in the second group the induction and maintenance of anaesthesia was performed with propofol, alongside the local anaesthesia with lidocaine was administered; the third group was administered propofol and inhalation anaesthesia with sevoflurane, excluding epidural anaesthesia. Monitoring was carried out according to the intraoperative indicators, post-anaesthesia recovery time, postoperative indicators of fear and pain, Apgar scores in puppies, the number of survivors and deaths in the short-term (30 minutes) and medium-term (during the day) periods.Results. The best intra- and postoperative indicators as well as the highest percentage of surviving puppies and the smallest number of stillbirths were revealed in patients of the first group. Medium results were recorded in the third group. The lowest intraoperative indicators in the function of cardiovascular and respiratory systems and the worst results as of hypoxia in newborn puppies were recorded in the second group of studied animals.Discussion and Conclusion. When determining the most efficient anaesthetic care for caesarean section in dogs, it should be borne in mind that propofol has a depressing effect on the respiratory and cardiovascular systems of patients, therefore its use is highly undesirable for the anaesthesia maintenance. Unlike propofol, sevoflurane does not penetrate the placenta barrier, is not metabolised and enables quick awakening of a bitch from anaesthesia. Moreover, in cases, when sevoflurane was used, the Apgar scores in the born puppies were the highest. Epidural anaesthesia with lidocaine reduces the postoperative pain of a bitch after caesarean section and has a positive effect on lactation. The use of epidural anaesthesia may be complicated with hypotension, however, the preventive use of crystalloid solutions, can mitigate this effect. Thus, the protocol with triple anaesthesia is optimal and preferable for caesarean section in dogs: induction with propofol, epidural anaesthesia with lidocaine and inhalation with sevoflurane to maintain anaesthesia.