Veterinary journal (London, England : 1997) · 2026
Choosing wisely: Effects of propofol and alfaxalone induction on maternal and neonatal outcomes in isoflurane-anesthetized dogs undergoing cesarean section.
СтатьяRandomized Controlled Trial, VeterinaryНазвание и аннотация: Перевод пока не подготовлен
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Antończyk Agnieszka, Ligocka-Kowalczyk Zuzanna, Ochota Małgorzata
Аннотация
UNLABELLED: The choice of anesthetic protocol for canine cesarean section (CS) remains debated, with maternal stability and neonatal outcomes as key concerns. Propofol and alfaxalone are both used for induction, but comparative data on their intraoperative and neonatal effects are limited. The objective of this study was to compare propofol and alfaxalone for induction, each followed by isoflurane maintenance during Cesarean section (CS) in bitches, with respect to maternal hemodynamics, anesthetic requirements, neonatal vitality, and umbilical cord blood parameters.
METHODS: Thirty-five bitches undergoing elective CS were randomly assigned to propofol-isoflurane (PROP, n = 17) or alfaxalone-isoflurane (ALFA, n = 18) induction. Maternal vital signs and isoflurane requirements were monitored intraoperatively. Umbilical cord blood samples were analyzed for gases and electrolytes. Neonatal vitality was assessed using a modified Apgar score at 0, 5, and 20 min.
RESULTS: Both protocols provided generally stable anesthesia, but hypotension episodes were more frequent in ALFA dams after fetal removal (44.4% vs. 17.7%) and at the closure (66.7% vs. 17.7%). Isoflurane requirements were higher in the ALFA group. Neonates from ALFA dams showed higher umbilical cord pH (7.19 ± 0.09 vs. 7.16 ± 0.08) and lower pCO₂ (64.4 ± 16.0 vs. 72.3 ± 16.6 mmHg). At 20 min, Apgar scores were significantly higher in the ALFA group (8.22 ± 0.95 vs. 7.79 ± 0.59). All puppies survived the first week of life.
CONCLUSIONS: Alfaxalone induction was associated with reduced neonatal acidosis and improved vitality compared with propofol, though it increased maternal isoflurane requirements and hypotension risk later in surgery. Alfaxalone-isoflurane may offer neonatal advantages, but close monitoring of maternal blood pressure is essential.
METHODS: Thirty-five bitches undergoing elective CS were randomly assigned to propofol-isoflurane (PROP, n = 17) or alfaxalone-isoflurane (ALFA, n = 18) induction. Maternal vital signs and isoflurane requirements were monitored intraoperatively. Umbilical cord blood samples were analyzed for gases and electrolytes. Neonatal vitality was assessed using a modified Apgar score at 0, 5, and 20 min.
RESULTS: Both protocols provided generally stable anesthesia, but hypotension episodes were more frequent in ALFA dams after fetal removal (44.4% vs. 17.7%) and at the closure (66.7% vs. 17.7%). Isoflurane requirements were higher in the ALFA group. Neonates from ALFA dams showed higher umbilical cord pH (7.19 ± 0.09 vs. 7.16 ± 0.08) and lower pCO₂ (64.4 ± 16.0 vs. 72.3 ± 16.6 mmHg). At 20 min, Apgar scores were significantly higher in the ALFA group (8.22 ± 0.95 vs. 7.79 ± 0.59). All puppies survived the first week of life.
CONCLUSIONS: Alfaxalone induction was associated with reduced neonatal acidosis and improved vitality compared with propofol, though it increased maternal isoflurane requirements and hypotension risk later in surgery. Alfaxalone-isoflurane may offer neonatal advantages, but close monitoring of maternal blood pressure is essential.