buprenorphine use in caesarians

Re: buprenorphine use in caesarians

mariette asselbergs — Fri, 27 Jan 2012 21:46:25 GMT

In rural hospitals in Mozambique caesarian sections in people were done under ketamine +diazepam iv, apparently good painkillers and safe for woman and baby.

Mariette

Re: buprenorphine use in caesarians

HMC — Fri, 27 Jan 2012 17:40:00 GMT

[quote user="Martin Atkinson"]

[quote user="Hannah Bose"]

I was wondering what people use analgesia-wise for caesarians?

[/quote] Get banished to the 'New names' thread for that bastardisation of the English language.

[/quote]

Is that a bastardisation? Forgive me if it is. I usually pride myself on good use of english... Or should that be 'English'?

Re: buprenorphine use in caesarians

Martin Atkinson — Fri, 27 Jan 2012 16:28:15 GMT

[quote user="Hannah Bose"]

I was wondering what people use analgesia-wise for caesarians?

[/quote] Get banished to the 'New names' thread for that bastardisation of the English language. But seriously to answer the question: I'd GA with straight Alfaxan, usually about half recommended dose works (I used to use Saffan back in the day with an anti-histamine), mask down if I cant intubate straight away with isoflurane, then tube of course, give peri-operative buprenorphanol or butorphanol and carprofen as soon as the last pup is out.

Re: buprenorphine use in caesarians

Charlotte Marshall — Wed, 25 Jan 2012 22:59:56 GMT

We tend to give the analgesia once the pups are out. Partly because we felt we had a couple where the pups were sluggish after we had used vetergesic pre op. Could have been coincidence I suppose. I did ask about it at a cpd meeting once and that seemed to be their recommendation as well at the time. May just be a matter individual opinion.

Re: buprenorphine use in caesarians

Claire Fisher — Wed, 25 Jan 2012 20:46:14 GMT

[quote user="Utlendigur"]

[quote user="Claire Fisher"]One of our vets went on some anaesthesia/analgesia cpd recently and the recommendation was to give vetergesic pre op as apparently very little crosses the placenta [/quote]

Just wondering -given that it is quite slow to reach effect (45minutes plus?) is that a genuine "doesn't cross the placenta effect" of the drug or just that it doesn't kick in until the pups are out?

[/quote]

I understood it as genuinely doesn't cross the placenta but I can ask her tomorrow and clarify.

Re: buprenorphine use in caesarians

Utlendigur — Wed, 25 Jan 2012 20:29:45 GMT

Just wondering -given that it is quite slow to reach effect (45minutes plus?) is that a genuine "doesn't cross the placenta effect" of the drug or just that it doesn't kick in until the pups are out?

Re: buprenorphine use in caesarians

Mark Holmes — Wed, 25 Jan 2012 16:33:53 GMT

I would suggest looking up the effects of opiates on newborn humans. Admittedly a different species but much more info is available. Particularly sensitivity and longer duration of action than in adults. Pups are relatively less mature than human new borns. They are also much more likely to get squashed if sluggish. On the other hand their small body size means that volatile agents will be very quickly lost once they are breathing which can be assisted if needed.

Re: buprenorphine use in caesarians

Claire Fisher — Wed, 25 Jan 2012 16:13:32 GMT

One of our vets went on some anaesthesia/analgesia cpd recently and the recommendation was to give vetergesic pre op as apparently very little crosses the placenta and then an NSAID once the pups are out - we use Rimadyl as I believe it has a licence for use in lactation though not pregnancy.

Re: buprenorphine use in caesarians

Mark Rowland — Wed, 25 Jan 2012 15:52:12 GMT

I go: butorphanol, alfaxan, line block, sevo

Then buprenorphine post op

Re: buprenorphine use in caesarians

Andrew Kent — Wed, 25 Jan 2012 14:29:45 GMT

I believe current thinking is that an opioid pre-op is a better option as it allows a lower propofol dose and lower volatile percentage which both have a much more profound effect on puppy than opioid. Using something short acting like pethidine would be the best of the opioids. Andy

Re: buprenorphine use in caesarians

Mike Nikolaou — Wed, 25 Jan 2012 11:13:40 GMT

No analgesia pre-op (with a heavy heart!), induction with propofol and as soon as the pups are out I give meloxicam and buprenorphine i.v. (as they're licensed).

Re: buprenorphine use in caesarians

Mark Holmes — Wed, 25 Jan 2012 11:01:57 GMT

Straight propofol and vetergesic once the pups are out us the way I roll.