Alfaxalone for total intravenous anaesthesia in bitches undergoing elective caesarean section and its effects on puppies: a randomized clinical trial

Ruiz, Clara Conde; Carro, Andrea P Del; Rosset, Émilie; Guyot, Emilie; Maroiller, Laura; Buff, Samuel; Portier, Karine

doi:10.1111/vaa.12298

Cited by 37 publications

(28 citation statements)

References 21 publications

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“…The impact of anesthesia at C-section on outcomes for puppies is an important issue in canine reproduction. In the last years, several studies have been performed to assess the best protocol aimed to reduce fetal distress and maximize neonatal outcome [13,14,15,16]. However, the study of the possible effect of a drug on fetal distress and neonatal outcome could be affected by several factors, namely the methods to assess fetal distress or newborn viability, the clinical requirement of C-section (emergency or planned), and the type of anesthesia protocol [13,14,15,16].…”

Section: Introductionmentioning

confidence: 99%

“…In the last years, several studies have been performed to assess the best protocol aimed to reduce fetal distress and maximize neonatal outcome [13,14,15,16]. However, the study of the possible effect of a drug on fetal distress and neonatal outcome could be affected by several factors, namely the methods to assess fetal distress or newborn viability, the clinical requirement of C-section (emergency or planned), and the type of anesthesia protocol [13,14,15,16]. Furthermore, also the health and the management of the pregnant bitch could influence the fetal well-being and development [17,18], and, when an elective C-section is planned, also the identification of the correct day for surgery, in terms of physiologic end of pregnancy and fetal maturation for birth is pivotal [18,19,20,21,22,23,24].…”

Section: Introductionmentioning

confidence: 99%

“…Anesthesia induction with alfaxalone at elective and emergency C-section was also qualified as equivalent to propofol in terms of neonatal vitality [15], but in this case the evaluation of puppies was less objective as it was assessed scoring straightening, suction, ano-genital, and flexion reflexes. Finally, anesthesia maintenance by alfaxalone in continuous rate infusion (CRI) was attempted at elective C-section, but its results were inadvisable in clinical practice compared to isoflurane, because it lowers the neonatal Apgar score and maternal recovery quality, and it requires repeated rescue boluses and high total dosages of alfaxalone, implying slow procedures [16]. The lighter depth of anesthesia obtained by alfaxalone CRI was also supposed to be responsible for a higher arterial blood pressure [16].…”

Section: Introductionmentioning

confidence: 99%

“…Finally, anesthesia maintenance by alfaxalone in continuous rate infusion (CRI) was attempted at elective C-section, but its results were inadvisable in clinical practice compared to isoflurane, because it lowers the neonatal Apgar score and maternal recovery quality, and it requires repeated rescue boluses and high total dosages of alfaxalone, implying slow procedures [16]. The lighter depth of anesthesia obtained by alfaxalone CRI was also supposed to be responsible for a higher arterial blood pressure [16].…”

Section: Introductionmentioning

confidence: 99%

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

Melandri

Alonge

Peric

et al. 2019

Animals

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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.AbstractAttention 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.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Melandri

Alonge

Peric

et al. 2019

Animals

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“…A anestesia total intravenosa com alfaxalona foi testada em cadelas para procedimento de cesariana, no qual os autores observaram um escore APGAR e recuperação da mãe ligeiramente menor nesses casos se comparado ao isoflurano (RUIZ et al, 2016). No entanto a taxa de sobrevivência não alterou entre os grupos.…”

Section: Uso Em Cesarianasunclassified

O Uso De Alfaxalona Em Pequenos Animais

Santos¹,

Fontanela²,

Taffarel³

2018

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RESUMOA alfaxalona é um esteroide neuroativo sintético capaz de induzir a anestesia por meio da ativação de receptores de ácido gama-aminobutírico. Tem como efeito adverso mínimo depressão respiratória e cardiovascular. A alfaxalona também não promove crescimento bacteriano. Essa revisão teve por objetivo relatar o uso clínico de alfaxalona em pequenos animais (cães e gatos), através da sua farmacocinética, farmacodinâmica, doses e vias de administração, uso na indução, analgesia promovida, utilização em infusão contínua, como ocorre a recuperação e o uso em cesárias, promovendo o conhecimento sobre esse fármaco e seus benefícios para os veterinários brasileiros. Em conclusão a utilização de alfaxalona na rotina anestésica de pequenos animais possui diversas vantagens, desde que sejam atentados os efeitos adversos para cada individualidade do paciente e ocorra a implantação de um protocolo correto. PALAVRAS-CHAVE: anestesia, cão, gato. THE USE OF ALFAXALONE IN SMALL ANIMALS ABSTRACTAlfaxalone is a synthetic neuroactive steroid capable of inducing anesthesia through the activation of gamma-aminobutyric acid receptors. It has as adverse effect only a minimal respiratory depression, presenting mainly apnea. However, it promotes minimal cardiovascular depression soon after induction. Alfaxalone also does not promote bacterial growth. This review aimed to report the clinical use of alfaxalone in small animals (dogs and cats), through its pharmacokinetics, pharmacodynamics, doses and routes of administration, use in induction, promoted analgesia, use in continuous infusion, recovery and use in cesareans. Aiming to promote knowledge about this drug and its benefits for Brazilian veterinarians. In conclusion, the use of alfaxalone in the anesthetic routine of small animals has several advantages, as long as the adverse effects for each individuality of the patient are observed and the implementation of a correct protocol occurs.

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The Dental Patient and Its General Conditions

Eberspächer-Schweda

2021

The Veterinary Dental Patient

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Alfaxalone for total intravenous anaesthesia in bitches undergoing elective caesarean section and its effects on puppies: a randomized clinical trial

Cited by 37 publications

References 21 publications

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

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

O Uso De Alfaxalona Em Pequenos Animais

The Dental Patient and Its General Conditions

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