Comparison of alfaxalone versus propofol as anaesthetic induction agents in increasing the rate of survival and vigour of neonates

Lesca Monica Sofyan,Fernando Martinez-Taboada

doi:10.18849/ve.v6i2.344

Abstract

PICO question In routine canine caesareans, is alfaxalone a superior anaesthetic induction agent than propofol in increasing the rate of survival and vigour of neonates?  Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Three randomised positive clinical trials have compared the efficacy between alfaxalone and propofol in routine canine caesarean sections for increased neonatal survival and vigour Strength of evidence Weak Outcomes reported Although two studies found alfaxalone to be associated with higher Apgar scores for neonates than propofol, each study nonetheless revealed positive vigour and high survival rates from the use of either alfaxalone or propofol. The evidence is too weak to suggest that one induction agent is superior to another. The selection between the two induction agents may not be the main concern in regard to neonatal depression and 24 hour survival post-delivery, provided that the entire canine caesarean protocol is thoroughly and carefully studied Conclusion Text here  How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care. 

Highlights

Indications for dystocia included poor general condition of the dam, neonates were in feto-maternal disproportion or position, the heart rates of the neonates were considered very low (
Assessment of preoperative parameters Age, parity, body weight, heart rate, respiratory rate, packed cell volume, total protein and temperature did not differ between the alfaxalone and propofol group
Assessment of intra-operative parameters Temperature, anaesthetic duration, heart rate, mean blood pressure, delivery time and puppies delivered by caesarean did not differ between the alfaxalone and propofol

Summary

A Knowledge Summary by

Lesca Monica Sofyan BaAVBS(HonsII) MVS DVM 1* Fernando Martinez Taboada LV CertVA PGCert(Biostats) DipECVAA 2. PICO question In routine canine caesareans, is alfaxalone a superior anaesthetic induction agent than propofol in increasing the rate of survival and vigour of neonates?. The selection between the two induction agents may not be the main concern in regard to neonatal depression and 24 hour survival post-delivery, provided that the entire canine caesarean protocol is thoroughly and carefully studied Conclusion The evidence is too weak to suggest that alfaxolone or propofol is superior to another during canine cesareans. To ensure best practice and aid in the development of a gold standard anaesthetic protocol for routine canine caesareans for your practice, you aim to research if one induction agent may be superior to one another in increasing neonatal survival and vigour. Each article directly compared alfaxalone and propofol in canine caesarean sections and analysed outcomes related to the welfare of the bitch, vigour and survival rate of the neonates

Summary of the evidence

Limitations:

Findings

Methodology Section