Use of propofol-isoflurane as an anesthetic regimen for cesarean section in dogs.

OBJECTIVE: To evaluate use of propofol-isoflurane as an anesthetic regimen for cesarean section in dogs and to compare this protocol with epidural analgesia and anesthesia induced with thiopental sodium. DESIGN: Prospective study. ANIMALS: 141 bitches admitted for cesarean section. PROCEDURE: General anesthesia was induced with propofol in 141 dogs undergoing cesarean section. After intubation, anesthesia was maintained by means of inhalation of isoflurane (0.5 to 2.0%), administered in a 65:35 mixture of oxygen:nitrous oxide. After induction, 20 minutes were allowed to elapse before delivery of puppies was begun. Viability of neonates was ascertained immediately after surgery. Owners were interviewed by telephone to determine survival of puppies during the postoperative period. Survival rates from this study were compared with those from cesarean section performed on dogs under epidural analgesia or under general anesthesia induced with thiopental sodium. RESULTS: Induction, maintenance, and recovery were problem free in all bitches. Of 412 puppies delivered by cesarean section, 293 (71%) survived, 13 (3%) were born alive but died within 20 minutes of delivery, and 106 (26%) were stillborn. Survival rate for puppies from dams induced with propofol-isoflurane was similar to that for puppies from dams receiving epidural analgesia. Survival rate for puppies delivered by cesarean section performed on dams under general anesthesia was higher for dams induced with propofol than for dams induced with thiopental sodium. CLINICAL IMPLICATIONS: General anesthesia induced with propofol and maintained with isoflurane is acceptable for performing cesarean section in dogs.

Pharmacoeconomics of propofol versus thiopental for induction of anaesthesia in short procedures.

This study compared the costs and benefits of using propofol/fentanyl versus thiopental/fentanyl for induction of anaesthesia in short procedures. A prospective, cohort trial was conducted in conjunction with a patient survey. The study population included a consecutive sample of American Society of Anaesthesiologists. Class I or II patients who underwent short operative procedures and who were given one of the studied anaesthetic regimens. Insoflurane/N2O was used for maintenance of anaesthesia in all cases. Propofol patients showed a significantly shorter time to eye opening (p = 0.0025); orientation to date of birth, place, and day of week (p = 0.0002); time to consciousness (p = 0.0019); and time in recovery room (p = 0.013); but not time to tolerating 50 mL of oral fluid (p = 0.06). Nausea and vomiting occurred in 41% of thiopental patients and 19% of propofol patients (difference 22%; 95% C.I., -1% to 44%). Based on survey results, propofol patients subjectively reported fewer side effects upon returning home and were able to resume daily activities earlier than thiopental patients. With the current staffing and patient load at our institution, an estimated 4.8 hours of nursing time per day would be made available if propofol were used in place of thiopental for induction of anaesthesia in these procedures. If propofol were used for all daycare surgery patients in our institution, the annual acquisition cost is projected to be $60,331.28 versus $8,079.68 for thiopental.(ABSTRACT TRUNCATED AT 250 WORDS)