Anesthesia and analgesia for caesaren section in dog

Abstract

This work presents a case of a pregnant female dog, of English bulldog breed, three years old, which was brought to Belgrade Faculty of Veterinary Medicine because of inability for normal parturition. Cesarean section is an urgent intervention both in human and in veterinary medicine. Anesthesia of a pregnant dog should be carried out very carefully, because of all the physiological changes that appear during pregnancy, as well as the impact of anesthetics on embryos themselves. Anesthetics, analgesics and sedatives pass through blood brain barrier, but also their transport goes through placenta to embryo, so for that reason it is not possible to anesthetize only mother and to avoid anesthesia effects on the embryo. Therefore, anesthetics with short time of action which metabolize quickly and have minimal negative effect on embryos are recommended. When choosing the right analgesics and anesthetics, there should be known that female dogs in which it is necessary to do Cesarean section belong to the group of high risk patients. Pregnant female dogs are exposed to hypoventilation, hypoxia, hypercapnia, intense heart work, vomiting and regurgitation as well. Reversible anesthetics are recommended to provide shorter duration time of anesthesia, and in accordance, inhalation anesthetics doses are minimal. Application of ɑ2-agonist in premedication, propophol in induction, as well as maintaining general inhalation anesthesia with sevofluran, along with local analgesia, proved to be the ideal combination in this case of cesarean section.

U ovom radu je prikazan slučaj gravidné kuje, rase engleski buldog, starosti tri godine, koja je zbog nemogućnosti normalnog porođaja bila dovedena na Fakultet veterinarske medicine u Beogradu. Carski rez je urgentna intervencija, kako u humanoj, tako i u veterinarskoj medicini. Anesteziju gravidne kuje treba vrlo oprezno obaviti, jer se moraju uzeti u obzir sve fiziološke promene koje nastaju u toku graviditeta, kao i uticaj anestetika na same plodove. Anestetici, analgetici i sedativi prolaze krvno-moždanu barijeru, ali se takođe i njihov transport vrši preko placente do ploda iz tog razloga nije moguće anestezirati samo majku, a da anestezija nema efekte i na plodove. Preporučuju se anestetici koji imaju kratko vreme delovanja, koji se brzo metabolišu i imaju minimalan negativan uticaj na plodove. Prilikom izbora odgovarajućeg analgetika i anestetika treba znati da kuje kod kojih je neophodno obaviti carski rez spadaju u grupu visoko rizičnih pacijenata. Gravidne kuje su izložene hipoventilaciji, hipoksiji, hiperkapniji, pojačanom radu srca, povraćanju i regurgitaciji. Reverzibilni anestetici se preporučuju iz razloga da vreme trajanja anestezije bude što kraće, a doze inhalacionih anestetika su minimalne. Primena ɑ2-agonista u premedikaciji, propofola u indukciji i održavanje opšte inhalacione anestezije sa sevofluranom uz lokalnu analgeziju su se kod ovog slučaja carskog reza pokazali kao idealna kombinacija.