Apgar scores in puppies following the induction of etomidate compared with alfaxalone or propofol for cesarean section

Research (Published online: 05-03-2024)

3. Apgar scores in puppies following the induction of etomidate compared with alfaxalone or propofol for cesarean section

Thanikul Srithunyarat, Supranee Jitpean, Piyasak Wipoosak, Chalermkwan Nonthakotr, Nitaya Boonbal, Panisara Kunkitti, and Suvaluk Seesupa

Veterinary World, 17(3): 527-534

Thanikul Srithunyarat: Division of Surgery, Faculty of Veterinary Medicine, Khon Kaen University, 40002, Thailand.

Supranee Jitpean: Division of Surgery, Faculty of Veterinary Medicine, Khon Kaen University, 40002, Thailand.

Piyasak Wipoosak: Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Khon Kaen University, 40002, Thailand.

Chalermkwan Nonthakotr: Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Khon Kaen University, 40002, Thailand.

Nitaya Boonbal: Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Khon Kaen University, 40002, Thailand.

Panisara Kunkitti: Division of Theriogenology, Faculty of Veterinary Medicine, Khon Kaen University, 40002, Thailand.

Suvaluk Seesupa: Division of Surgery, Faculty of Veterinary Medicine, Khon Kaen University, 40002, Thailand.

Background and Aim: The Apgar score is a useful assessment of neonatal viability in dogs. The Apgar score in puppies born by cesarean section can be lower than vaginal delivery because all anesthetic drugs can cross the placenta. Therefore, anesthetic drugs with minimal cardiorespiratory effect and rapid elimination are recommended for cesarean section. The present study aimed to compare Apgar scores in puppies born after the induction of etomidate, alfaxalone or propofol, and those maintained with isoflurane inhalation during cesarean section.

Materials and Methods: Thirty-six bitches were equally divided in the three anesthetic drug groups. Modified Apgar scores were assessed at 5, 15, and 60 min after delivery. Intraoperative vital signs and Apgar scores were compared using a linear mixed model and adjusted pairwise comparisons using Bonferroni analysis.

Results: A total of 125 puppies were included in this study. Age, body weight, litter size, type of surgery, delivery time, anesthetic and surgical duration, and intraoperative vital signs did not significantly differ between the groups. Puppies in the alfaxalone and propofol groups had significantly higher Apgar scores than the etomidate group in both elective and emergency surgery. In elective surgery, Apgar scores at 5 min after delivery did not differ significantly between groups. At 15 and 60 min after delivery, Apgar scores in the etomidate group were significantly lower than those in the other groups. In emergency surgery, Apgar scores were significantly lower in the etomidate group than in the alfaxalone group at all time points.

Conclusion: Induction with alfaxalone and propofol resulted in better outcomes with higher Apgar scores and neonatal viability than etomidate. Therefore, alfaxalone and propofol should be used as anesthetic induction drugs in both elective and emergency cesarean sections.

The document is a research article that compares the Apgar scores in puppies born after the induction of different anesthetic drugs during cesarean section.

The Apgar score is a useful assessment of neonatal viability in puppies born by cesarean section.

The study compared Apgar scores in puppies born after the induction of etomidate, alfaxalone, or propofol for cesarean section.

Puppies in the alfaxalone and propofol groups had significantly higher Apgar scores than the etomidate group in both elective and emergency surgery.

Induction with alfaxalone and propofol resulted in better outcomes with higher Apgar scores and neonatal viability than etomidate, suggesting that alfaxalone and propofol should be used as anesthetic induction drugs in both elective and emergency cesarean sections.

Alfaxalone is recommended as an anesthetic induction drug for canine cesarean section, followed by isoflurane maintenance.

Apgar scores at 5 minutes after delivery were better in the alfaxalone group compared to the propofol group, indicating less respiratory depression with alfaxalone.

The Apgar scores of puppies born in the first litter of the dam were lower than those born in the second to fourth litter, and litter size over nine puppies had a negative effect on Apgar scores.

French Bulldogs have a high incidence of congenital defects and a high mortality rate, with cleft palate being a common defect.

Factors associated with neonatal mortality in cesarean section include fetal hypoxia, obstruction in the pelvic canal, and anesthetic duration of more than 80 minutes.