Choosing Wisely: Effects of propofol and alfaxalone induction on maternal and neonatal outcomes in isoflurane-anesthetized dogs undergoing cesarean section.

Alfaxalone improves neonatal outcomes but requires vigilant maternal hypotension monitoring.

This randomized controlled trial compared propofol and alfaxalone induction protocols, each followed by isoflurane maintenance, in 35 bitches undergoing elective cesarean section. The study evaluated maternal hemodynamic stability, anesthetic requirements, and neonatal outcomes including umbilical cord blood parameters and Apgar scores. While both protocols provided generally stable anesthesia, the alfaxalone-isoflurane group experienced significantly higher hypotension episodes after fetal removal (44.4% vs. 17.7%) and at surgical closure (66.7% vs. 17.7%), requiring increased isoflurane supplementation. However, neonates from alfaxalone-anesthetized dams demonstrated superior outcomes: higher umbilical cord pH (7.19 vs. 7.16), lower pCO₂ (64.4 vs. 72.3 mmHg), and significantly higher Apgar scores at 20 minutes (8.22 vs. 7.79). All puppies survived the first postoperative week. The findings suggest alfaxalone provides neonatal advantages by reducing fetal acidosis and improving vitality, though clinicians must closely monitor maternal blood pressure during and after surgery. This evidence supports selective use of alfaxalone in high-risk pregnancies prioritizing neonatal viability while implementing enhanced hemodynamic monitoring protocols.

This summary was distilled by AI and may occasionally misinterpret data. Confirm critical details with the primary literature before clinical application.