Effects of Alfaxalone or Propofol on Giant-Breed Dog Neonates Viability During Elective Caesarean Sections.

Monica Melandri,Barbara Bolis,Maria C Veronesi,Tanja Peric,Salvatore Alonge

doi:10.3390/ani9110962

Monica Melandri, Barbara Bolis + Show 3 more

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https://doi.org/10.3390/ani9110962

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Abstract

Simple SummaryNowadays, thanks to the increased awareness of owners and breeders and to the most recent techniques available to veterinarians, the management of parturition, especially of C-sections, has become a topic of greater importance. Anesthesia is crucial and must be targeted to both the mother and neonates. The present study aimed to evaluate the effect of the induction agent alfaxalone on the vitality of puppies born from elective C-section, in comparison to propofol. After inducing general anesthesia for elective C-section, puppies from the mothers induced with alfaxalone had higher 5-min Apgar scores than those induced with propofol. The concentration of cortisol in fetal fluids collected at birth is neither influenced by the anesthetic protocol used, nor does it differ between amniotic and allantoic fluids. Nevertheless, the cortisol concentration in fetal fluids affects the relationship between anesthesia and the Apgar score: the present study highlights a significant relationship between the anesthetic protocol used and Apgar score in puppies, and fetal fluids cortisol concentration acts as a covariate of this relationship. Alfaxalone is a safe and effective drug for the induction of anesthesia in dogs, and it can be successfully employed for elective C-section, with neonatal wellbeing improvements.Attention must be paid to C-section anesthesia effects on mother and offspring. Alfaxalone induction results in improved puppy viability when compared to propofol. The present study aims to evaluate effects of alfaxalone or propofol induction for elective C-section on newborns, expressed as Apgar score and fetal fluids cortisol concentration. Anesthesia was induced with alfaxalone 3 mg/kg iv in 5 bitches (group A), and propofol 4 mg/kg iv in another 5 (group P), maintained with isoflurane. Amniotic and allantoic fluids were collected to determine cortisol concentration. Apgar score, litter size, newborn gender, birth-weight, maternal age, and parity were recorded. ANOVA, U Mann-Whitney test and ANCOVA assessed the effects of drugs on the Apgar score and fetal fluids cortisol. Thirty-six puppies were randomly selected for the study: 16 from group A and 20 from group P. Only the Apgar score significantly differed between groups. ANCOVA confirmed a significantly higher Apgar score in group A underlining the influence of fetal fluids cortisol concentrations, both resulting in covariates. Present results confirm the effect of anesthesia on the Apgar score of newborns, which is significantly higher for alfaxalone than propofol, suggesting the use of fetal fluids cortisol as a covariate. These findings could be a starting point for further investigations when less viable puppies are detected or expected, such as during an emergency C-section.

Highlights

In dogs, as in other species, at Caesarean sections (C-sections) that are either planned or occur in an emergency, particular attention must be paid to anesthesia effects on both the mother and the offspring.On the maternal side, the so-called “gestational anti-nociception” must be taken into account [1,2,3], allowing reduced drug dosages by 25% [4], and decreasing the isoflurane mean alveolar concentration (MAC) by 28%/40% [5,6]
ANCOVA confirmed a significantly higher Apgar score in group A underlining the influence of fetal fluids cortisol concentrations, both resulting in covariates
Present results confirm the effect of anesthesia on the Apgar score of newborns, which is significantly higher for alfaxalone than propofol, suggesting the use of fetal fluids cortisol as a covariate

Summary

Introduction

The so-called “gestational anti-nociception” must be taken into account [1,2,3], allowing reduced drug dosages by 25% [4], and decreasing the isoflurane mean alveolar concentration (MAC) by 28%/40% [5,6]. The latter is reported in ewes [5] and humans [6], but it can be reasonably extended to other species, including dogs. Even if the existence of the aorto-caval syndrome was never demonstrated in dogs [8,9,10], a supplementary fluid therapy must be given to face the potential systemic hypotension, resulting from the extraction of the uterus from the abdomen, in a so called “vacuum phenomenon” [11]

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