Cesarean section in dogs: Anesthetic management

Cesarean section is common in small animal veterinary practice. Preoperative assessment should include a complete history, a physical examination, a laboratory database, and diagnostic imaging as dictated by a patients status. Premedication can decrease maternal stress and anxiety and permits a decrease in the dose of injectable induction drugs and in the minimum alveolar concentration of inhalation anesthetics. Premedication agents that can be reversed (e.g., opioids, benzodiazepines) are preferred. All animals under-going anesthesia for cesarean section should receive intravenous fluid therapy. Preoxygenation before and during induction significantly decreases the risk of maternal hypoxemia. General anesthesia is preferred over epidural-only anesthesia even though epidural anesthesia has the fewest depressant effects on neonates. Anesthetic protocols that use propofol and isoflurane are associated with decreased maternal and neonatal mortality and increased puppy vigor Protocols that include alpha(2)-agonists, ketamine, or methoxyflurane should be avoided because they have been associated with increased maternal and fetal mortality and decreased neonatal vigor Monitoring maternal ventilation, arterial oxygenation, blood pressure, and temperature during anesthesia is very important in cesarean section to permit early detection and treatment of adverse changes in these parameters,The importance of tailoring a specific anesthetic protocol to an individual animal is stressed.