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Luevitoonvechakij N, Buranapim N, Suriyasathaporn W, Bansiddhi P, Warrit K, Punyapornwithaya V, Suriyasathaporn W. Cadaveric Study on Comparison of Neck Extension Angles for Endotracheal Intubation in Rabbits Using a Rigid and Flexible Endoscope. Animals (Basel) 2024; 14:1270. [PMID: 38731275 PMCID: PMC11083616 DOI: 10.3390/ani14091270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Endotracheal intubation in rabbits is always challenging due to the unique anatomical conformation. To improve endotracheal intubation success, this study determined the relationship between head placement angles guided by endoscope-assisted visualization techniques and the endotracheal intubation success rate. Thirty-two rabbit cadavers were used in the study. Six veterinary practitioners who had no experience with rabbit endotracheal intubation were randomly assigned to intubate rabbit cadavers using the guidance of either a rigid endoscope (RE) or flexible endoscope (FE), with the head placement angles with an ascending neck at 90, 100, 110, 120 and 130 degrees. The endotracheal intubation completed in 90 s was determined to be a success. The success rates using RE and FE were 97.2% and 95.9%, respectively. The means and standard error of means (SEM) of endotracheal intubation times guided by RE and FE were 53.7 ± 4.68 and 55.2 ± 4.24 s, respectively. Results from survival time analysis show that the five veterinarians successfully intubated the rabbit within 90 s, regardless of the different types of endoscopes. Angle was the only significant factor that affected the endotracheal intubation success. The head placement angle at 110 and 120 degrees had the highest success rate of endotracheal intubation compared to 90 degrees (p ≤ 0.05). In conclusion, for inexperienced veterinarians, the success of endotracheal intubation in rabbits, guided by endoscope-assisted visualized techniques regardless of rigid endoscope or flexible endoscope guidance, is improved when the head extension is 110 and 120 degrees.
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Affiliation(s)
- Nicharee Luevitoonvechakij
- Graduate Program in Veterinary Science, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50100, Thailand;
- Center of Elephant and Wildlife Health, Chiang Mai University Animal Hospital, Chiang Mai University, Chiang Mai 50100, Thailand;
| | - Nithidol Buranapim
- Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50100, Thailand; (N.B.); (W.S.); (K.W.); (V.P.)
| | - Witaya Suriyasathaporn
- Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50100, Thailand; (N.B.); (W.S.); (K.W.); (V.P.)
- Research Center of Producing and Development of Products and Innovations for Animal Health and Production, Chiang Mai University, Chiang Mai 50100, Thailand
- Asian Satellite Campuses Institute, Nagoya University, Nagoya 464-8603, Japan
| | - Pakkanut Bansiddhi
- Center of Elephant and Wildlife Health, Chiang Mai University Animal Hospital, Chiang Mai University, Chiang Mai 50100, Thailand;
- Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50100, Thailand; (N.B.); (W.S.); (K.W.); (V.P.)
| | - Kanawee Warrit
- Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50100, Thailand; (N.B.); (W.S.); (K.W.); (V.P.)
| | - Veerasak Punyapornwithaya
- Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50100, Thailand; (N.B.); (W.S.); (K.W.); (V.P.)
| | - Wanna Suriyasathaporn
- Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50100, Thailand; (N.B.); (W.S.); (K.W.); (V.P.)
- Research Center of Producing and Development of Products and Innovations for Animal Health and Production, Chiang Mai University, Chiang Mai 50100, Thailand
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Retrospective comparison of the effects of laryngeal mask and endotracheal tube on some cardio-respiratory variables in pet rabbits undergoing anaesthesia for elective gonadectomy. Acta Vet Scand 2023; 65:10. [PMID: 36859294 PMCID: PMC9976375 DOI: 10.1186/s13028-023-00673-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 02/22/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Endotracheal intubation in rabbits is challenging and supraglottic airway devices, such as laryngeal masks (LMA), represent an alternative as they are easy to insert, and do not stimulate the larynx requiring therefore a lighter plane of anaesthesia for their insertion and positioning than the endotracheal tubes. We investigated whether, compared to an endotracheal tube, the LMA can reduce the negative effects of general anaesthetics on some cardiovascular and respiratory parameters routinely monitored in rabbits anaesthetized for elective gonadectomy. The records of 21 adult mixed breed pet rabbits were collected retrospectively. Rabbits were divided in two groups based on the type of airway device used. A laryngeal mask secured the airway in group LMA (n = 11), and in group ETT (n = 10) an endotracheal tube was used. The amount of propofol used before successful insertion of the airway device was recorded. A pitot-based spirometer was connected and ventilatory variables were measured immediately after insertion. Pulse rate, non-invasive arterial blood pressure, haemoglobin oxygen saturation, respiratory rate, end-tidal carbon dioxide and volatile anaesthetic consumption were also monitored during the surgical procedure; extubation time was noted as well. RESULTS The use of LMA required significantly less propofol (0.8 to 4 mg/kg) for insertion than the ETT (1.2 to 5.6 mg/kg), and the difference was statistically significant (P < 0.01). No differences were observed in ventilatory variables measured immediately after airway positioning. Intraoperatively, there were no differences between groups for respiratory and cardiovascular variables, and amount of isoflurane administered. In all rabbits mean and diastolic blood pressure progressively decreased during surgery. Mean extubation time was shorter in group LMA (6 ± 2 min) than group ETT (8 ± 3 min, P < 0.01). CONCLUSION The airway device did not clinically affect the cardiovascular and respiratory variables during anaesthesia. Intraoperative hypoventilation was observed in most rabbits regardless of the device being used; therefore ventilatory support may be required. Rabbits with the laryngeal masks were extubated earlier.
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Lambertini C, Grandis A, De Silva M, Cassano IA, Checcacci Carboni S, Romagnoli N. The Spritztube: A New Device for the Extraglottic Intubation of Rabbits. Animals (Basel) 2022; 13:ani13010156. [PMID: 36611764 PMCID: PMC9817887 DOI: 10.3390/ani13010156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/27/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
The Spritztube (ST) is an extraglottic airway device developed for humans. The aim of the study was to design an ST for rabbits and to evaluate its feasibility. The study was divided into two phases. Phase I: anatomical study on 12 rabbit cadavers to design 2 STs (8 and 10 Ch, external diameter) for rabbits. Phase II: fourteen privately owned rabbits were anaesthetised, and intubation was attempted using a ST. Tube size, the method for confirming the correct positioning, the number of attempts, the time needed for the correct positioning of the ST and complications were recorded. The ST placement was feasible in all rabbits. The positioning of the ST was completed in 2.1 ± 1 attempts in 43 ± 21.4 s. A correct placement was confirmed by the visualisation of the proximal cuff at visual inspection of the oral cavity (14/14), by the detection of the airflow (9/14 rabbits) and by the visualisation of a capnographic wave (14/14 rabbits). Only one rabbit developed respiratory distress after the ST placement. The results of the present study allowed designing a ST specific for rabbits which was used a supraglottic airway device for the maintenance of isoflurane anaesthesia in spontaneously breathing rabbits.
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Affiliation(s)
- Carlotta Lambertini
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Via Tolara di Sopra 50, Ozzano Emilia, 40064 Bologna, Italy
| | - Annamaria Grandis
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Via Tolara di Sopra 50, Ozzano Emilia, 40064 Bologna, Italy
| | - Margherita De Silva
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Via Tolara di Sopra 50, Ozzano Emilia, 40064 Bologna, Italy
| | | | | | - Noemi Romagnoli
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Via Tolara di Sopra 50, Ozzano Emilia, 40064 Bologna, Italy
- Correspondence:
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Abstract
With the increasing frequency of rabbits as veterinary patients, the expectation for high-quality, intensive veterinary care, and resultantly an understanding of anesthesia has been increasing. Sedation and general anesthesia are commonly required for many routine and emergency procedures in rabbits, and this results in the need for a strong awareness of anesthetic principles, knowledge of limitations of anesthesia, and maintenance of high standards of anesthesia.
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EVALUATION OF A LARYNGEAL MASK AIRWAY AS AN ALTERNATIVE TO OROTRACHEAL INTUBATION FOR MAINTAINING AIRWAY PATENCY DURING INHALANT ANESTHESIA UNDER SPONTANEOUS VENTILATION IN CAPYBARAS ( HYDROCHOERUS HYDROCHAERIS). J Zoo Wildl Med 2021; 52:276-286. [PMID: 33827186 DOI: 10.1638/2020-0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2020] [Indexed: 11/21/2022] Open
Abstract
Orotracheal intubation carries greater difficulty in rodents than in most domestic species. The human laryngeal mask airway (LMA) was compared with an endotracheal tube (ETtube) for maintaining airway patency in anesthetized capybaras (Hydrochoerus hydrochaeris). Six capybaras (24-52 kg) were remotely darted with intramuscular ketamine, midazolam, and acepromazine on two occasions (≥7-day intervals). After isoflurane mask induction for random placement of an ETtube or a LMA during each episode, anesthesia was maintained with isoflurane in oxygen under spontaneous ventilation for 90-120 min. Computed tomography of the pharynx and larynx was performed in two of six animals and three of six animals with the ETtube and LMA, respectively. End-tidal isoflurane [median (range)] was not significantly different between ETtube [0.6% (0.5-1.5%)] and LMA [0.6% (0.4-0.9%)]. Heart rate [67 ± 11 beats/min (ETtube) and 67 ± 18 beats/min (LMA)], mean arterial pressure [74 ± 13 mm Hg (ETtube) and 74 ± 14 mm Hg (LMA)], arterial CO2 tension [41 ± 2 mm Hg (ETtube) and 43 ± 4 mm Hg (LMA)], and arterial O2 tension [360 ± 59 mm Hg (ETtube) and 360 ± 63 mm Hg (LMA)] were not significantly different between treatment groups. Computed tomography showed gas in the esophagus with the LMA (three of three animals); the fit of the LMA to the larynx was adequate in two of three animals and fair in one of three animals. Recovery from anesthesia was uneventful. The LMA is a feasible alternative to the ETtube for maintaining airway patency during inhalant anesthesia in spontaneously breathing capybaras. However, the LMA may be dislodged during movement of the animal.
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Huckins GL, Doss GA, Ferreira TH. Evaluation of supraglottic airway device use during inhalation anesthesia in healthy African pygmy hedgehogs (Atelerix albiventris). Vet Anaesth Analg 2021; 48:517-523. [PMID: 33903071 DOI: 10.1016/j.vaa.2021.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate a supraglottic airway device (SGAD) designed for rabbits in African pygmy hedgehogs (Atelerix albiventris) during inhalation anesthesia. STUDY DESIGN Prospective, randomized, blinded experimental study. ANIMALS A total of 12 adult African pygmy hedgehogs (seven male, five female). METHODS Hedgehogs were placed in a chamber and anesthesia was induced using isoflurane in oxygen. Oropharyngeal endoscopy was performed and video recorded. The SGAD (v-gel R1) was inserted and connected to a Mapleson D circuit. Capnography, pulse oximetry and physiologic variables were measured during anesthesia, and lung inflation was tested at 10 and 20 cmH2O. With the SGAD temporarily disconnected, anesthetized hedgehogs were randomly positioned into right and left lateral, dorsal and sternal recumbency to evaluate the effect of a change in body position on SGAD placement. Oropharyngeal endoscopy was repeated at the end of anesthesia, and recovery time was recorded. Pre- and post-SGAD placement endoscopy videos were retrospectively reviewed and scored for gross trauma. RESULTS The median [interquartile range (IQR)] time to successful SGAD placement was 38 (16-68) seconds. The time to SGAD placement decreased as the study progressed. SGAD required repositioning in six hedgehogs, median 2.5 (IQR, 1-3.5) adjustments each, to successfully perform lung inflation or maintain capnography readings. Lung inflation at 10 cmH2O was successfully performed without leakage in nine animals, and in the other three animals after adjusting the SGAD at 1-2 time points. Inflation at 20 cmH2O was rarely achieved without an air leak. Changes in heart and respiratory rates during anesthesia were not clinically relevant. Median endoscopic scores were 0 (no lesions) for both pre-and postplacement. CONCLUSIONS AND CLINICAL RELEVANCE The SGAD was relatively quickly and easily placed, permitted lung inflation and caused no significant oropharyngeal damage. The SGAD is a practical option for airway management in African pygmy hedgehogs.
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Affiliation(s)
- Gail L Huckins
- Department of Surgical Sciences, University of Wisconsin-Madison, School of Veterinary Medicine, Madison, WI, USA
| | - Grayson A Doss
- Department of Surgical Sciences, University of Wisconsin-Madison, School of Veterinary Medicine, Madison, WI, USA.
| | - Tatiana H Ferreira
- Department of Surgical Sciences, University of Wisconsin-Madison, School of Veterinary Medicine, Madison, WI, USA
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Abstract
Abstract
Providing a secure airway management during general anesthesia could be problematic in some medical cases, especially when there is a risk of regurgitation and aspiration of the gastric content due to increased intragastric pressure. The current study aimed to test the applicability of two types of LMA in several animal species and to compare its effectiveness to the endotracheal intubation method in securing sealed airway respiration as an alternative to using endotracheal tubes. The study was conducted in dogs (n=33), cats (n=9), swine (n=9), rabbits (n=5), sheep (n=7) and roe deer (n=1). One or both types of laryngeal masks were used for each animal species: LMA Classic™-cLMA and LMA ProSeal™-PLMA. The assessment of each laryngeal mask was performed by determining the insertion technique, the possibilities of first-attempt insertion and malposition, the compliance with various animal species, ventilation time, cuff pressure, and sealing capacity. The highest LMA size compatility in dogs (23,87±14,30 kg) was size-3 in six and size-4 in forteen subjects; In swine (43,22±12,32 kg), size-4; In rabbits (3,84±0,36 kg) size-1; and in sheep (48,29±4,65 kg) size-3 and size-4. Ventilation time was highest in swine and roe deer (121,11±42,85 min and 300,00 min, respectively) and lowest in cat (28,33±16,96 min). First-attempt LMA insertion success was lowest in rabbits (60%), and highest in sheep and roe deer (100%). Malposition was with highest rate in rabbits (40%) and lowest in cat, sheep and roe deer (0%). Gastric reflux was most frequently observed in sheep (71,4%) and roe deer (100%). The usage of LMA in the veterinary anesthetic practice significantly improves airway management in animals during general anesthesia. The inflated LMA cuff does not prevent its disposition. Therefore, both the drain and respiratory tubes must be fixed. The usage of LMA in rabbits was associated with higher incidence of malposition and other complications. Our findings suggest that LMA designed for humans can be used for airway management in veterinary medicine.
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Comparison of blind intubation and a smartphone-based endoscope-assisted intubation in rabbits. Vet Anaesth Analg 2020; 47:826-834. [PMID: 32981837 DOI: 10.1016/j.vaa.2020.07.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/23/2020] [Accepted: 07/28/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To compare between blind and smartphone-based endoscope-assisted techniques for endotracheal intubation in rabbits. STUDY DESIGN Prospective clinical study. ANIMALS A total of 34 rabbits. METHODS Rabbits were assigned to four groups: intubation by a veterinary anesthesiologist (VA) or an exotic pet medicine specialist (EPS) using blind or endoscope-assisted techniques. Propofol dose, number of attempts until successful intubation, total time for intubation, duration of the successful attempt and occurrence of lingual cyanosis/laryngeal lesions were recorded. Data were analyzed by t test, Wilcoxon-Mann-Whitney U test or chi-square test. Pearson correlation for body weight was performed. RESULTS The success rate of blind intubation was 88.9% and 77.8% for VA and EPS, respectively. Propofol dose, total and median number of attempts, total time for intubation and duration of the successful attempt were 3.1 (0-6.2) mg kg-1, 19, 2 (1-5), 79 ± 65 and 30 ± 20 seconds for VA and 1.5 (0-4.5) mg kg-1, 24, 3 (1-5), 136 ± 92 and 38 ± 16 seconds for EPS. The success rate of endoscope-assisted intubation was 87.5% for both operators. Propofol dose, total and median number of attempts, total time for intubation and duration of the successful attempt were 2.5 (1.3-7.4) mg kg-1, 22, 3 (1-5), 170 (65-368) and 46 (22-150) seconds for VA and 3.2 (0-6) mg kg-1, 11, 1 (1-4), 56 (27-432) and 55 (26-79) seconds for EPS. VA performed blind intubation more quickly, propofol dose was lower and cyanosis was less frequent than in the endoscope-assisted group. CONCLUSIONS AND CLINICAL RELEVANCE Both techniques were reliable for rabbit endotracheal intubation. Best results were achieved when the operator was experienced in the technique. The smartphone-based endoscope is a useful aid for rabbit intubation.
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Ferris RL, Quesenberry KE, Weisse CW. Outcome of intraluminal tracheal stent placement for tracheal stenosis in a rabbit (Oryctolagus cuniculus). J Exot Pet Med 2019. [DOI: 10.1053/j.jepm.2019.04.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Vieitez V, Ezquerra LJ, López Rámis V, Santella M, Álvarez Gómez de Segura I. Retrograde intubation in a dog with severe temporomandibular joint ankylosis: case report. BMC Vet Res 2018; 14:118. [PMID: 29587754 PMCID: PMC5872398 DOI: 10.1186/s12917-018-1439-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 03/21/2018] [Indexed: 11/26/2022] Open
Abstract
Background Orotracheal intubation in dogs is a common and easily-performed procedure that provides a patent airway during anaesthesia. In dogs with temporomandibular joint ankylosis or pseudo-ankylosis, airway management can be a challenging procedure since these dogs have a limited ability to open their mouth. Methods to provide safe, uneventful intubation in such patients may include minimally invasive techniques such as retrograde intubation using a guide wire and fibre-optic-aided laryngoscopy. Case presentation We report a case of a 16-month-old, intact female Bull Terrier weighing 17 kg, admitted to the hospital for surgical treatment of bilateral ankylosis of the temporomandibular joint. Intubation was achieved, without direct observation of the larynx, by retrograde intubation using a vascular access catheter and a vascular wire guide through cricothyroid membrane. Bilateral condylectomy was performed and the dog recovered uneventfully. Conclusions In conclusion, retrograde intubation was relatively simple to perform with the guide wire technique and no specific training or equipment were necessary.
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Affiliation(s)
- Verónica Vieitez
- Veterinary Teaching Hospital, University of Extremadura, Avda, Universidad s/n, 10003, Cáceres, Spain.
| | - Luis Javier Ezquerra
- Veterinary Teaching Hospital, University of Extremadura, Avda, Universidad s/n, 10003, Cáceres, Spain
| | - Víctor López Rámis
- Veterinary Teaching Hospital, University of Extremadura, Avda, Universidad s/n, 10003, Cáceres, Spain
| | - Massimo Santella
- Veterinary Teaching Hospital, University of Extremadura, Avda, Universidad s/n, 10003, Cáceres, Spain
| | - Ignacio Álvarez Gómez de Segura
- Department of Animal Medicine and Surgery, Veterinary Faculty, University Complutense of Madrid, Avda. Puerta de Hierro, 28040, Madrid, Spain
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Thompson KL, Meier TR, Scholz JA. Endotracheal Intubation of Rabbits Using a Polypropylene Guide Catheter. J Vis Exp 2017. [PMID: 29155771 PMCID: PMC5755377 DOI: 10.3791/56369] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Endotracheal intubation in rabbits can be challenging due to their unusual anatomy. Achieving a patent airway during anesthesia is critical for the avoidance of airway obstruction, prevention of gastric tympany, and to allow ventilatory support. Due to the difficulty of intubation, alternative methods such as the use of laryngeal mask airways or laryngeal tubes have been explored. However, these methods do not result in direct access to the trachea and thus may present a risk for development of complications. In addition, lack of direct intubation of the trachea can result in personnel exposure to waste anesthetic gases. Numerous methods for endotracheal intubation have been described, including blind placement, use of a fiberoptic laryngoscope or endoscope, and cricoid placement. Despite these numerous publications, many still struggle to achieve success. Here we provide a detailed description of an intubation technique that can be taught with minimal training with a short time to proficiency. Briefly, after administration of injectable anesthesia and proper positioning of the rabbit, a polypropylene catheter is placed into the trachea by direct visualization using a laryngoscope. The catheter is then used as a guide to direct the endotracheal tube into the trachea. This method allows for intubation without the need for expensive equipment and can be performed by a single individual without the need for an assistant. In conclusion, this technique can be easily taught and performed at very little cost in any clinical or research setting.
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Wenger S, Müllhaupt D, Ohlerth S, Prasse S, Klein K, da Silva Valente B, Mosing M. Experimental evaluation of four airway devices in anaesthetized New Zealand White rabbits. Vet Anaesth Analg 2017; 44:529-537. [DOI: 10.1016/j.vaa.2016.05.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 04/28/2016] [Accepted: 05/03/2016] [Indexed: 10/20/2022]
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Engbers S, Larkin A, Rousset N, Prebble M, Jonnalagadda M, Knight CG, Pang DSJ. Comparison of a Supraglottic Airway Device (v-gel ®) with Blind Orotracheal Intubation in Rabbits. Front Vet Sci 2017; 4:49. [PMID: 28443290 PMCID: PMC5385366 DOI: 10.3389/fvets.2017.00049] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 03/22/2017] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Achieving a secure airway in rabbits is generally considered more difficult than in cats or dogs. Their relatively large tongue, small oropharyngeal cavity and glottis limit direct visualization. A rabbit-specific supraglottic airway device (SGAD) may offer benefits over blind orotracheal intubation. ANIMALS AND METHODS Fifteen adult New Zealand white rabbits were randomized to SGAD or orotracheal intubation (ETT). All animals were sedated with dexmedetomidine (0.1 mg kg-1 IM) and midazolam (0.5 mg kg-1 IM), followed by induction with alfaxalone (0.3 mg kg-1 IV). Two CT scans of the head and neck were performed, following sedation and SGAD/ETT placement. The following were recorded: time to successful device insertion, smallest cross-sectional airway area, airway sealing pressure, and histological score of tracheal tissue. Data were analyzed with a Mann-Whitney test. RESULTS Two rabbits were excluded following failed ETT. Body masses were similar [ETT; n = 6, 2.6 (2.3-4.5) kg, SGAD; n = 7, 2.7 (2.4-5.0) kg]. SGAD placement was significantly faster [33 (14-38) s] than ETT [59 (29-171) s]. Cross-sectional area (CSA) was significantly reduced from baseline [12.2 (6.9-3.4) mm2] but similar between groups [SGAD; 2.7 (2.0-12.3) mm2, ETT; 3.8 (2.3-6.6) mm2]. In the SGAD group, the device tip migrated into the laryngeal vestibule in 6/7 rabbits, reducing the CSA. ETT airway seals were higher [15 (10-20) cmH2O], but not significant [SGAD; 5 (5-20) cmH2O, p = 0.06]. ETT resulted in significantly more mucosal damage [histological score 3.3 (1.0-5.0)], SGAD; 0.67 (0.33-3.67). CONCLUSION The SGAD studied was faster to place and caused less damage than orotracheal intubation, but resulted in a similar CSA.
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Affiliation(s)
- Sarah Engbers
- Cochrane Veterinary Care Clinic, Cochrane, AB, Canada
| | - Amy Larkin
- Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Nicolas Rousset
- Western Veterinary Specialist and Emergency Centre, Calgary, AB, Canada
| | - Melanie Prebble
- Western Veterinary Specialist and Emergency Centre, Calgary, AB, Canada
| | | | - Cameron G Knight
- University of Calgary Faculty of Veterinary Medicine (UCVM), Calgary, AB, Canada
| | - Daniel S J Pang
- Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada.,Groupe de recherche en pharmacologie animale du Québec (GREPAQ), Université de Montréal, Saint-Hyacinthe, QC, Canada
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Barletta M, Kleine SA, Quandt JE. Assessment of v-gel supraglottic airway device placement in cats performed by inexperienced veterinary students. Vet Rec 2015; 177:523. [DOI: 10.1136/vr.103407] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2015] [Indexed: 12/26/2022]
Affiliation(s)
- M. Barletta
- Department of Large Animal Medicine; College of Veterinary Medicine, University of Georgia; Athens GA 30602 USA
| | - S. A. Kleine
- Department of Small Animal Medicine & Surgery; College of Veterinary Medicine, University of Georgia; Athens GA 30602 USA
| | - J. E. Quandt
- Department of Small Animal Medicine & Surgery; College of Veterinary Medicine, University of Georgia; Athens GA 30602 USA
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Richardson D. A comparison of the v-gel® supraglottic airway device and non-cuffed endotracheal tube in the time to first capnograph trace during anaesthetic induction in rabbits. ACTA ACUST UNITED AC 2015. [DOI: 10.12968/vetn.2015.6.7.426] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Morath U, Skogmo HK, Ranheim B, Levionnois OL. The use of bougie‐guided insertion of a laryngeal mask airway device in neonatal piglets after unexpected complications. VETERINARY RECORD CASE REPORTS 2014. [DOI: 10.1136/vetreccr-2013-000040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Ute Morath
- Department of Veterinary Anaesthesiology and Pain TherapyVetsuisse FacultyUniversity of BernLaenggassstrasse 124Bern3012Switzerland
| | - Hege Kippenes Skogmo
- Department of Companion Animal Clinical SciencesNorwegian School of Veterinary ScienceOsloNorway
| | - Birgit Ranheim
- Department of Food Safety & Infection Biology Section of Veterinary Pharmacology and ToxicologyNorwegian Veterinary SchoolPO Box 8146 DepOslo0033Norway
| | - Olivier Louis Levionnois
- Department of Veterinary Anaesthesiology and Pain TherapyVetsuisse FacultyUniversity of BernLaenggassstrasse 124Bern3012Switzerland
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Crotaz IR. An observational clinical study in cats and rabbits of an anatomically designed supraglottic airway device for use in companion animal veterinary anaesthesia. Vet Rec 2013; 172:606. [DOI: 10.1136/vr.100668] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- I. R. Crotaz
- Harmans Water Veterinary Centre; Ralphs Ride, Harmans Water Bracknell Berkshire RG12 9LG UK
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18
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Crotaz IR. Initial feasibility investigation of the v-gel airway: an anatomically designed supraglottic airway device for use in companion animal veterinary anaesthesia. Vet Anaesth Analg 2010; 37:579-80. [DOI: 10.1111/j.1467-2995.2010.00566.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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Application of the Laryngeal Mask Airway for Anesthesia in Three Chimpanzees and One Gibbon. J Zoo Wildl Med 2010; 41:535-7. [DOI: 10.1638/2009-0120.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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20
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Sideri AI, Galatos AD, Kazakos GM, Gouletsou PG. Gastro-oesophageal reflux during anaesthesia in the kitten: comparison between use of a laryngeal mask airway or an endotracheal tube. Vet Anaesth Analg 2009; 36:547-54. [DOI: 10.1111/j.1467-2995.2009.00499.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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21
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Yamamoto Y, Inoue S, Abe R, Kawaguchi M, Furuya H. Airway management with the laryngeal tube in rabbits. Lab Anim (NY) 2007; 36:33-5. [PMID: 17450168 DOI: 10.1038/laban0507-33] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2007] [Accepted: 03/15/2007] [Indexed: 11/09/2022]
Abstract
The rabbit's oropharyngeal anatomy complicates the use of endotracheal intubation for airway management during surgical procedures. To determine if the laryngeal tube is useful for airway management in rabbits, the authors applied the device and evaluated its efficacy to ventilate the lungs. The laryngeal tube was inserted blindly and without difficulty in six healthy male New Zealand White rabbits; all of the rabbits were ventilated adequately with and without neuromuscular blockade. The authors conclude that the laryngeal tube can be used as an alternative means of airway management in rabbits.
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Affiliation(s)
- Yuri Yamamoto
- Department of Anesthesiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
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