Anesthesia for Cesarean Section and Associated Outcomes in the Bitch in Nairobi County, Kenya

Abstract

esarean section (CS) refers to the surgical delivery of neonates by hysterotomy, and it is often performed to relieve dystocia. Dystocia is a complication associated with any impediment to initiate or complete labour, as a result of either maternal factors, fetal factors or a combination of both. A major maternal factor in dystocia, is physiological derangement occasioned by pregnancy. Management of dystocia through CS requires prudent choice of anesthetics and anesthetic adjuncts to minimize deleterious outcomes like morbidity or mortality for both the dam and the fetuses/puppies. Despite advances in veterinary anesthesiology, no single anesthetic protocol exists for use in every cesarean section performed in pregnant beaches. Furthermore, information on the frequency of anesthetic protocols, outcomes and challenges encountered when CS is performed in pregnant bitches in Nairobi County is scant, thus, the need for the study. The main objective of this study was to survey and document anesthesia regiments for cesarean section in bitches and an associated outcomes in Nairobi County. Furthermore, identifying challenges encountered in managing cesarean section in bitches in Nairobi County was just as important. The study was two phased. The first phase was a retrospective study where patient records over a 12 year period were retrieved from 5 selected veterinary practices and examined for data and information on CS procedures. Data that included breed, age, parity, preoperative assessment of bitch and fetus-in-utero, and presentation of the bitch whether, emergency or elective was captured. In addition, information regarding pre-anesthetic management of the patients; drugs used for premedication, induction and maintenance of anesthesia; analgesia, fluid therapy and outcomes of the CS in bitches and puppies was also extracted from the records. Phase two was a cross-sectional study in which a questionnaire was administered to veterinary practitioners and it focused on perioperative activities associated with CS as well as challenges faced by veterinarians when managing bitches undergoing CS. Data and information generated formed the basis for descriptive statistics which were generated for anesthetic protocols, post operative pain management and outcomes of the cesarean sections in bitches and puppies. Logistic regression model was used to evaluate the determinants of the outcomes of CS...