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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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Nejamkin P, Clausse M, Landivar F, Lorenzutti MA, Cavilla V, Viviani P, Alvarez LI, Del Sole MJ. Development and evaluation of an anatomically designed and 3D printed device to enhance orotracheal intubation success in rabbits by inexperienced veterinarians. Vet Anaesth Analg 2023; 50:273-279. [PMID: 36967327 DOI: 10.1016/j.vaa.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 03/01/2023] [Accepted: 03/01/2023] [Indexed: 03/12/2023]
Abstract
OBJECTIVE To assess whether the use of a three-dimensional (3D) printed device enhances the success rate of orotracheal intubation in rabbits. STUDY DESIGN Prospective, crossover randomized controlled trial. ANIMALS A total of six mixed-breed rabbits. METHODS A device to guide the endotracheal tube was designed based on computed tomography images and then manufactured using 3D printing. Rabbits were randomly assigned for intubation by two inexperienced veterinarians using the blind (BLI), borescope- (BOR) or device- (DEV) guided techniques. Success rate, number of attempts, time to success, injury scores and propofol dose were recorded and compared. Significance was considered when p < 0.05. RESULTS Success rate was higher in DEV (58.3%) than in BLI (8.3%) (p < 0.023), but not different from that in BOR (41.6%). Total time until successful intubation was lower in DEV (45 ± 23 seconds) and BOR (85 ± 62 seconds) than in BLI (290 seconds; p < 0.006). Time for the successful attempt was lower for DEV (35 ± 10 seconds) and BOR (74 ± 43 seconds) than in BLI (290 seconds; p < 0.0001). The propofol dose required was lower for DEV (2.3 ± 1.2 mg kg-1) than for BLI (3.4 ± 1.6 mg kg-1) (p < 0.031), but not different from BOR (2.4 ± 0.9 mg kg-1). Number of attempts and oxygen desaturation events were not different among techniques (p < 0.051 and p < 0.326, respectively). Injury scores [median (range)] before and after attempts were different in BLI [0 versus 1 (0-3), p < 0.005] and BOR [0 (0-1) versus 1 (0-3), p < 0.002] but not in DEV [0 (0-2) versus 0 (0-3), p < 0.109]. CONCLUSIONS AND CLINICAL RELEVANCE The device facilitated orotracheal intubation with a time similar to the borescope-guided technique but faster than the traditional blind technique.
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Affiliation(s)
- Pablo Nejamkin
- Universidad Nacional del Centro de la Provincia de Buenos Aires, Facultad de Ciencias Veterinarias, MEVET, Tandil, BA, Argentina; CIVETAN, UNCPBA-CONICET, Tandil, BA, Argentina.
| | - María Clausse
- Universidad Nacional del Centro de la Provincia de Buenos Aires, Facultad de Ciencias Veterinarias, MEVET, Tandil, BA, Argentina; CIVETAN, UNCPBA-CONICET, Tandil, BA, Argentina
| | - Florencia Landivar
- Universidad Nacional del Centro de la Provincia de Buenos Aires, Facultad de Ciencias Veterinarias, MEVET, Tandil, BA, Argentina
| | - Matías A Lorenzutti
- Facultad de Ciencias Agropecuarias, IRNASUS CONICET - Universidad Católica de Córdoba, CB, Argentina
| | - Verónica Cavilla
- Universidad Nacional del Centro de la Provincia de Buenos Aires, Facultad de Ciencias Veterinarias, MEVET, Tandil, BA, Argentina
| | - Paula Viviani
- Universidad Nacional del Centro de la Provincia de Buenos Aires, Facultad de Ciencias Veterinarias, MEVET, Tandil, BA, Argentina; Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Luis I Alvarez
- CIVETAN, UNCPBA-CONICET, Tandil, BA, Argentina; Universidad Nacional del Centro de la Provincia de Buenos Aires, Facultad de Ciencias Veterinarias, FISFARVET, Tandil, BA, Argentina
| | - María J Del Sole
- Universidad Nacional del Centro de la Provincia de Buenos Aires, Facultad de Ciencias Veterinarias, MEVET, Tandil, BA, Argentina
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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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Scardia A, Laricchiuta P, Stabile M, Acquafredda C, Lacitignola L, Uva A, Crovace A, Staffieri F. Use of Laryngeal Mask and Anesthetic Management in Hamadryas Baboons ( Papio hamadryas) Undergoing Laparoscopic Salpingectomy-A Case Series. Vet Sci 2023; 10:vetsci10020158. [PMID: 36851462 PMCID: PMC9965857 DOI: 10.3390/vetsci10020158] [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: 12/01/2022] [Revised: 01/08/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023] Open
Abstract
The study aims to describe the anesthetic and airway management of baboons (Papio hamadryas) undergoing laparoscopic salpingectomy with a laryngeal mask airway (LMA) device. Eleven baboons received tiletamine-zolazepam and medetomidine; anesthesia was induced with propofol. An LMA was positioned for oxygen and isoflurane administration in spontaneous respiration. Heart rate (HR), mean arterial pressure (MAP), respiratory rate (RR), end tidal carbon dioxide (EtCO2), minute volume (MV), and peripheral hemoglobin oxygen saturation (SpO2) were recorded before (PREPP) and immediately after abdomen insufflation (PP1), at 10 (PP2), 20 (PP3), and 30 (PP4) minutes during pneumoperitoneum, and after (POSTPP) pneumoperitoneum. The respiratory rate was significantly higher at all times compared to PREPP. The end tidal carbon dioxide concentration was significantly higher at PP2, PP3, PP4, and POSTPP, compared to the previous times. The higher values for RR and EtCO2 were registered at PP4: 22.7 (95% CI 17.6-27.8) breaths/min and 57.9 (95% CI 51.9-63.8) mmHg, respectively. The minute volume was significantly higher at PP4 and POSTPP compared to the other times. The higher value for MV was registered at POSTPP (269.1 (95% CI 206.1-331.8) mL/kg/min). This protocol is suitable for baboons undergoing laparoscopic salpingectomy. The LMA was easy to insert and allowed for good ventilation, gas exchange, and delivery of the anesthetic in spontaneous breathing baboons.
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Affiliation(s)
- Annalaura Scardia
- Ph.D. Course in “Tissues and Organs Transplantations and Cellular Therapies”, D.E.O.T., University of Bari, 70121 Bari, Italy
- Section of Veterinary Clinics and Animal Production, D.E.O.T., University of Bari, 70123 Bari, Italy
| | | | - Marzia Stabile
- Section of Veterinary Clinics and Animal Production, D.E.O.T., University of Bari, 70123 Bari, Italy
| | - Claudia Acquafredda
- Ph.D. Course in “Tissues and Organs Transplantations and Cellular Therapies”, D.E.O.T., University of Bari, 70121 Bari, Italy
| | - Luca Lacitignola
- Section of Veterinary Clinics and Animal Production, D.E.O.T., University of Bari, 70123 Bari, Italy
| | - Annamaria Uva
- Section of Veterinary Internal Medicine, DiMeV, University of Bari, 70010 Bari, Italy
| | - Antonio Crovace
- Section of Veterinary Clinics and Animal Production, D.E.O.T., University of Bari, 70123 Bari, Italy
| | - Francesco Staffieri
- Section of Veterinary Clinics and Animal Production, D.E.O.T., University of Bari, 70123 Bari, Italy
- Correspondence:
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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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Oberoi G, Eberspächer-Schweda MC, Hatamikia S, Königshofer M, Baumgartner D, Kramer AM, Schaffarich P, Agis H, Moscato F, Unger E. 3D Printed Biomimetic Rabbit Airway Simulation Model for Nasotracheal Intubation Training. Front Vet Sci 2020; 7:587524. [PMID: 33330714 PMCID: PMC7728614 DOI: 10.3389/fvets.2020.587524] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 10/22/2020] [Indexed: 11/29/2022] Open
Abstract
Rabbit inhalation anesthesia by endotracheal intubation involves a higher risk among small animals owing to several anatomical and physiological features, which is pathognomonic to this species of lagomorphs. Rabbit-specific airway devices have been designed to prevent misguided intubation attempts. However, it is believed that expert anesthetic training could be a boon in limiting the aftermaths of this procedure. Our research is aimed to develop a novel biomimetic 3D printed rabbit airway model with representative biomechanical material behavior and radiodensity. Imaging data were collected for two sacrificed rabbit heads using micro-computed tomography (μCT) and micro-magnetic resonance imaging for the first head and cone beam computed tomography (CBCT) for the second head. Imaging-based life-size musculoskeletal airway models were printed using polyjet technology with a combination of hard and soft materials in replicates of three. The models were evaluated quantitatively for dimensional accuracy and radiodensity and qualitatively using digital microscopy and endoscopy for technical, tactic, and visual realism. The results displayed that simulation models printed with polyjet technology have an overall surface representation of 93% for μCT-based images and 97% for CBCT-based images within a range of 0.0-2.5 mm, with μCT showing a more detailed reproduction of the nasotracheal anatomy. Dimensional discrepancies can be caused due to inadequate support material removal and due to the limited reconstruction of microstructures from the imaging on the 3D printed model. The model showed a significant difference in radiodensities in hard and soft tissue regions. Endoscopic evaluation provided good visual and tactile feedback, comparable to the real animal. Overall, the model, being a practical low-cost simulator, comprehensively accelerates the learning curve of veterinary nasotracheal intubation and paves the way for 3D simulation-based image-guided interventional procedures.
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Affiliation(s)
- Gunpreet Oberoi
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
- Department of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - M. C. Eberspächer-Schweda
- Department/Hospital for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Sepideh Hatamikia
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
- Austrian Center for Medical Innovation and Technology, Wiener Neustadt, Austria
| | - Markus Königshofer
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Doris Baumgartner
- Department/Hospital for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | | | - Peter Schaffarich
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Hermann Agis
- Department of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Francesco Moscato
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Ewald Unger
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
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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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Medina Serra R, Dominguez S, Vilalta L, Palacios C. Ultrasound‐guided epidural nerve block in a domestic dwarf rabbit (
Oryctolagus cuniculus
) undergoing ovariohysterectomy. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2020-001071] [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)
- Roger Medina Serra
- Anaesthesia and AnalgesiaRoyal Veterinary College Department of Veterinary Clinical SciencesHatfieldUK
| | - Sheyla Dominguez
- Departamento de Medicina y Cirugía AnimalFacultad de VeterinariaUniversidad Católica de Valencia San Vicente MártirValenciaSpain
| | | | - Carolina Palacios
- Clinical Services DivisionRoyal Veterinary CollegeHatfieldHertfordshireUK
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Rousseau-Blass F, Pang DS. Hypoventilation following oxygen administration associated with alfaxalone-dexmedetomidine-midazolam anesthesia in New Zealand White rabbits. Vet Anaesth Analg 2020; 47:637-646. [PMID: 32727673 DOI: 10.1016/j.vaa.2020.04.012] [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: 06/20/2019] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the relationship between oxygen administration and ventilation in rabbits administered intramuscular alfaxalone-dexmedetomidine-midazolam. STUDY DESIGN Prospective, randomized, blinded study. ANIMALS A total of 25 New Zealand White rabbits, weighing 3.1-5.9 kg and aged 1 year. METHODS Rabbits were anesthetized with intramuscular alfaxalone (4 mg kg-1), dexmedetomidine (0.1 mg kg-1) and midazolam (0.2 mg kg-1) and randomized to wait 5 (n = 8) or 10 (n = 8) minutes between drug injection and oxygen (100%) administration (facemask, 1 L minute-1). A control group (n = 9) was administered medical air 10 minutes after drug injection. Immediately before (PREoxy/air5/10) and 2 minutes after oxygen or medical air (POSToxy/air5/10), respiratory rate (fR), pH, PaCO2, PaO2, bicarbonate and base excess were recorded by an investigator blinded to treatment allocation. Data [median (range)] were analyzed with Wilcoxon, Mann-Whitney U and Kruskal-Wallis tests and p < 0.05 considered significant. RESULTS Hypoxemia (PaO2 < 88 mmHg, 11.7 kPa) was observed at all PRE times: PREoxy5 [71 (61-81) mmHg, 9.5 (8.1-10.8) kPa], PREoxy10 [58 (36-80) mmHg, 7.7 (4.8-10.7) kPa] and PREair10 [48 (32-64) mmHg, 6.4 (4.3-8.5) kPa]. Hypoxemia persisted when breathing air: POSTair10 [49 (33-66) mmHg, 6.5 (4.4-8.8) kPa]. Oxygen administration corrected hypoxemia but was associated with decreased fR (>70%; p = 0.016, both groups) and hypercapnia (p = 0.016, both groups). Two rabbits (one per oxygen treatment group) were apneic (no thoracic movements for 2.0-2.5 minutes) following oxygen administration. fR was unchanged when breathing air (p = 0.5). PaCO2 was higher when breathing oxygen than air (p < 0.001). CONCLUSIONS AND CLINICAL RELEVANCE Early oxygen administration resolved anesthesia-induced hypoxemia; however, fR decreased and PaCO2 increased indicating that hypoxemic respiratory drive is an important contributor to ventilation using the studied drug combination.
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Affiliation(s)
- Frédérik Rousseau-Blass
- Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada; Groupe de recherché en pharmacologie animale du Québec (GREPAQ), Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Daniel Sj Pang
- Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada; Groupe de recherché en pharmacologie animale du Québec (GREPAQ), Université de Montréal, Saint-Hyacinthe, QC, Canada; Department of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada.
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13
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Sayce LJ, Powell ME, Kimball EE, Chen P, Gartling GJ, Rousseau B. Continuous Rate Infusion of Ketamine Hydrochloride and Dexmedetomidine for Maintenance of Anesthesia during Laryngotracheal Surgery in New Zealand White Rabbits ( Oryctolagus cuniculus). JOURNAL OF THE AMERICAN ASSOCIATION FOR LABORATORY ANIMAL SCIENCE : JAALAS 2020; 59:176-185. [PMID: 32005295 PMCID: PMC7073403 DOI: 10.30802/aalas-jaalas-19-000076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 06/17/2019] [Accepted: 08/23/2019] [Indexed: 11/05/2022]
Abstract
New Zealand white rabbits (Oryctolagus cuniculus) are an established in vivo model for the study of structural and functional consequences of vocal-fold vibration. Research design requires invasive laryngotracheal procedures, and the presence of laryngospasms or pain responses (or both) hinder phonation-related data collection. Published anesthesia regimens report respiratory depression and muscle tone changes and have been unsuccessful in mitigating autonomic laryngeal responses in our protocol. Infusion of ketamine hydrochloride and dexmedetomidine hydrochloride in pediatric medicine provides effective analgesia and sedation for laryngotracheal procedures including intubation and bronchoscopy; however, data evaluating the use of ketamine-dexmedetomidine infusion in rabbits are unavailable. This study reports a new infusion regimen, which was used in 58 male New Zealand white rabbits that underwent a nonsurvival laryngotracheal procedure to induce phonotraumatic vocal-fold injury. Animals were sedated by using ketamine hydrochloride (20 mg/kg IM) and dexmedetomidine (0.125 mg/kg IM). Maintenance anesthesia was provided by using continuous rate intravenous infusion of ketamine hydrochloride (343 μg/kg/min) and dexmedetomidine (1.60 μg/kg/min). A stable plane of anesthesia with no autonomic laryngeal response (laryngospasm) was achieved in 32 of the 58 rabbits (55%). Laryngospasms occurred in 25 of 58 animals (43%) and were controlled in 20 cases (80%) by providing 0.33 mL 2% topical lidocaine, incremental increase in infusion rate, or both. Continuous rate infusion of ketamine hydrochloride-dexmedetomidine with prophylactic topical lidocaine provides a predictable and adjustable surgical plane of anesthesia, with minimal confounding respiratory and autonomic laryngeal responses, during extended-duration laryngotracheal surgery in rabbits. This regimen should be considered as an alternative to injection maintenance for prolonged, invasive procedures.
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Affiliation(s)
- Lea J Sayce
- Department of Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Otolaryngology, Vanderbilt University, Nashville, Tennessee;,
| | - Maria E Powell
- Department of Otolaryngology, Vanderbilt University, Nashville, Tennessee
| | - Emily E Kimball
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, Tennessee
| | - Patty Chen
- Animal Care and Use Review Office, US Army Medical Research and Development, Frederick, Maryland
| | - Gary J Gartling
- Department of Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Bernard Rousseau
- Department of Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Otolaryngology, Vanderbilt University, Nashville, Tennessee
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14
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Ong BHE, Hidaka Y, Kaneko Y, Yamamoto S, Mizutani S, Sekiguchi S, Torisu S, Naganobu K. Effects of a single-bolus bupivacaine injection into the coccygeal spinal canal of rabbits. J Vet Med Sci 2020; 82:197-203. [PMID: 31969542 PMCID: PMC7041980 DOI: 10.1292/jvms.19-0555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
It has been reported that drugs intended for epidural administration through the
lumbosacral junction are accidentally administered into the subarachnoid space frequently
in rabbits. Therefore, we evaluated the epidural single-bolus injection technique for the
administration of bupivacaine into the coccygeal spinal canal of rabbits. After epidural
distribution was confirmed by the injection of iohexol into the coccygeal spinal canal,
0.3 ml/kg 0.5% bupivacaine or 0.3 ml/kg normal saline
was injected via the same needle. After the first attempt of iohexol injection, although
the contrast was found in the epidural space in all rabbits, the additional contrast was
also found in blood vessel in 3 rabbits and in muscular layer in 1 rabbit. Subarachnoid
distribution was not observed in any of the rabbits. The time taken to regain normal anal
reflex, movement of the hind limbs during walking, conscious proprioception of the hind
limbs, and pain sensation of the tail and left hind limb, following coccygeal spinal canal
injection, were significantly longer in the bupivacaine group than in the normal saline
group. These findings indicated that coccygeal epidural injection of bupivacaine in
rabbits may provide anesthesia for the hind limbs, perineum, and tail, but inadvertent
vascular entry of the epidural drug may occur.
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Affiliation(s)
- Benedict H E Ong
- Veterinary Teaching Hospital, Faculty of Agriculture, University of Miyazaki, 1-1 Gakuenkibanadai-Nishi, Miyazaki 889-2192, Japan
| | - Yuki Hidaka
- Veterinary Teaching Hospital, Faculty of Agriculture, University of Miyazaki, 1-1 Gakuenkibanadai-Nishi, Miyazaki 889-2192, Japan
| | - Yasuyuki Kaneko
- Veterinary Teaching Hospital, Faculty of Agriculture, University of Miyazaki, 1-1 Gakuenkibanadai-Nishi, Miyazaki 889-2192, Japan
| | - Shushi Yamamoto
- Veterinary Teaching Hospital, Faculty of Agriculture, University of Miyazaki, 1-1 Gakuenkibanadai-Nishi, Miyazaki 889-2192, Japan
| | - Shinya Mizutani
- Veterinary Teaching Hospital, Faculty of Agriculture, University of Miyazaki, 1-1 Gakuenkibanadai-Nishi, Miyazaki 889-2192, Japan
| | - Satoshi Sekiguchi
- Animal Infectious Disease and Prevention, Faculty of Agriculture, University of Miyazaki, 1-1 Gakuenkibanadai-Nishi, Miyazaki 889-2192, Japan
| | - Shidow Torisu
- Veterinary Teaching Hospital, Faculty of Agriculture, University of Miyazaki, 1-1 Gakuenkibanadai-Nishi, Miyazaki 889-2192, Japan
| | - Kiyokazu Naganobu
- Veterinary Teaching Hospital, Faculty of Agriculture, University of Miyazaki, 1-1 Gakuenkibanadai-Nishi, Miyazaki 889-2192, Japan
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15
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Ko WK, Kim SJ, Heo DN, Han IB, Kim S, Kwon IK, Sohn S. Double layers of gold nanoparticles immobilized titanium implants improve the osseointegration in rabbit models. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2019; 24:102129. [PMID: 31760162 DOI: 10.1016/j.nano.2019.102129] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 11/13/2019] [Accepted: 11/13/2019] [Indexed: 10/25/2022]
Abstract
Osseointegration is important in osteopenia and osteoporosis patients due to their low bone densities. Gold nanoparticles (GNPs) are greatly beneficial materials as osteogenic agents. The aim of this study is to investigate osseointegration between bones and double layers of GNP-immobilized titanium (Ti) implants. The physicochemical properties of the Ti surface were evaluated by scanning electron microscopy, by atomic force microscopy, by means of the contact angle using water drops, and by x-ray photoelectron spectroscopy. Osteogenic differentiation of human bone-marrow-derived mesenchymal stem cells was analyzed and showed the higher values in double layers of GNP (GNP2) groups. In addition, we performed an in vivo study using hydroxyapatite (HA) and GNP2 spine pedicle screws in ovariectomized (OVX) and SHAM rabbits. Osseointegration parameters also showed higher values in GNP2 than in HA groups. These findings suggest that implants with double layers of GNPs can be a useful alternative in osteoporotic patients.
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Affiliation(s)
- Wan-Kyu Ko
- Department of Neurosurgery, CHA Bundang Medical Center, CHA University, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea; Department of Biomedical Science, CHA University, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Seong Jun Kim
- Department of Neurosurgery, CHA Bundang Medical Center, CHA University, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea; Department of Biomedical Science, CHA University, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Dong Nyoung Heo
- Department of Dental Materials, School of Dentistry, Kyung Hee University, Dongdaemun-gu, Seoul, Republic of Korea
| | - In-Bo Han
- Department of Neurosurgery, CHA Bundang Medical Center, CHA University, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Sewha Kim
- Department of Pathology, CHA Bundang Medical Center, CHA University, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Il Keun Kwon
- Department of Dental Materials, School of Dentistry, Kyung Hee University, Dongdaemun-gu, Seoul, Republic of Korea
| | - Seil Sohn
- Department of Neurosurgery, CHA Bundang Medical Center, CHA University, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
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Abstract
Even when performed by skilled operators, locating the nerves can be challenging in small exotic pets; in such cases, the use of an electrical nerve stimulator may be useful to confirm the correct identification of the target nerve. Exotic animal anesthesia and analgesia have dramatically progressed over the past decade and continue to do so as more research and technologies develop. Technological advancements such as airway devices, endoscopic intubation techniques, positive intermittent pressure ventilators, and invasive and noninvasive blood pressure monitors have played a significant role in improving patient safety and the anesthetic outcomes of exotic animals.
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17
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Dos Santos Rocha A, Südy R, Fodor GH, Habre W, Peták F. Feasibility of forced oscillatory assessment of respiratory mechanics across a laryngeal mask airway in rabbits. Physiol Meas 2019; 40:065001. [PMID: 31051489 DOI: 10.1088/1361-6579/ab1f13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The forced oscillation technique (FOT) is the method of choice for assessment of respiratory tissue mechanics. A laryngeal mask airway (LMA) is increasingly used to secure the airways in subjects under sedation or general anesthesia. While FOT is routinely performed using an endotracheal tube (ETT), the accuracy of information about airway and tissue mechanics obtained with FOT using a LMA has not been characterized. Therefore, we compared the mechanical parameters obtained with FOT using LMA and ETT in rabbits. APPROACH FOT was performed through a LMA at normal and reduced oscillatory amplitudes in anesthetized and mechanically ventilated rabbits (n = 9) at positive end-expiratory pressures (PEEP) of 3 and 6 cmH2O. These measurements were repeated at normal amplitude for the same animal using an ETT. Airway resistance, inertance, respiratory tissue damping (G) and elastance (H) were measured under each condition by FOT. The potential bias of the distensible upper airways when FOT was applied using LMA was assessed with a simulation study. MAIN RESULTS Values of parameters reflecting airway mechanics were significantly higher when measured using LMA at both PEEPs and oscillatory amplitudes than with ETT. Conversely, regardless of the condition, there was a correlation (r = 0.89 both at normal and reduced amplitudes; p < 0.0001) with good agreement (mean bias of 8.8 cmH2O/l and 11.3 cmH2O/l) in H, whereas G was systematically lower when obtained with LMA than with ETT at PEEP 3 (21.1% ± 7.2% and 9.6% ± 6.9% at normal and reduced oscillatory amplitudes, respectively) and 6 cmH2O (15.1% ± 8.2%, 1.6% ± 9.4%, p < 0.05 for all). SIGNIFICANCE Mechanical properties of the airways and the respiratory tissues, particularly for respiratory tissue stiffness, can be reliably assessed using LMA. However, the involvement of a longer laryngo-tracheo-bronchial pathway when using LMA should be considered for airway resistance and inertance, whereas upper airway shunting may affect the assessment of respiratory tissue damping.
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Affiliation(s)
- Andre Dos Santos Rocha
- Unit for Anaesthesiological Investigations, Department of Acute Medicine, University of Geneva, Geneva,Switzerland
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18
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Affiliation(s)
- Adrianna Skarbek
- Anderson Moores Veterinary Specialists, The Granary, Bunstead Barns, Poles Lane, Hursley, Winchaster, Hampshire, SO21 2LL
| | - Karla Borland
- Anderson Moores Veterinary Specialists, The Granary, Bunstead Barns, Poles Lane, Hursley, Winchaster, Hampshire, SO21 2LL
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19
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Lee LY, Lee D, Ryu H, Han JH, Ko J, Tyler JW. Capnography-guided Endotracheal Intubation as an Alternative to Existing Intubation Methods in Rabbits. JOURNAL OF THE AMERICAN ASSOCIATION FOR LABORATORY ANIMAL SCIENCE 2019; 58:240-245. [PMID: 30626468 DOI: 10.30802/aalas-jaalas-17-000150] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Rabbits provide a unique challenge for routine endotracheal intubation in clinical practice because of various distinctive anatomic and physiologic features. Many previously proposed methods for endotracheal intubation in rabbits are limited by several factors, including the needs for expensive equipment and high levels of technical expertise. We evaluated capnography for its effectiveness in assisting endotracheal intubation in rabbits. New Zealand white rabbits were divided into 3 groups of 5 animals. In the first 2 groups, mainstream (nondiverting) or sidestream (diverting) capnography (MC and SC groups, re- spectively) was used; in the third group (LS group), a laryngoscope with a size 00 Miller blade was used to guide endotracheal tube placement. Anesthesia was induced through intramuscular administration of ketamine (10 mg/kg), medetomidine (0.1 mg/kg), and midazolam (1 mg/kg) mixed in the same syringe prior to administration. Intubation time was defined from the point of opening the jaws to the completion of the first capnogram after intubation. Intubation was accomplished successfully in all animals in both capnography groups, but 2 rabbits in the laryngoscopy group could not be intubated. Intubation time was compared among groups was compared by using one-way ANOVA, and posthoc Bonferroni testing was applied to isolate significant differences between groups. The intubation time (mean ± 1 SD) was 46.4 ± 12.6 s in the MC group, 147.2 ± 44.2 s in the SC group, and 385.0 ± 114.1 in the LS group, with intubation time significantly differing among all groups. In conclusion, both mainstream and sidestream capnography-guided endotracheal intubation techniques were more effective and efficient than conventional laryngoscope-guided endotracheal intubation in rabbits. Furthermore, mainstream capnography was preferred over sidestream capnography because mainstream capnography resulted in significantly shorter intubation times.
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Affiliation(s)
- Lyon Y Lee
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, California, USA
| | - Dongbin Lee
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, California, USA
| | - Hakhyun Ryu
- College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
| | - Janet H Han
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, California, USA
| | - Jungho Ko
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, California, USA
| | - John W Tyler
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, California, USA.
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20
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Abstract
Due to the lack of germline transmitting pluripotent stem cells (PSCs) cell lines and the extreme difficulty of somatic cell nuclear transfer (SCNT) in rabbit, the gene targeting technology in rabbit was lagging far behind those in rodents and in farm animals. As a result, the development and application of genetically engineered rabbit model are much limited. With the advent of gene editing nucleases, including ZFN, TALEN, and CRISPR/Cas9, it is now possible to produce gene targeting (i.e., knockout, knockin) rabbits with high success rates. In this chapter, we describe a comprehensive, step-by-step protocol for rabbit genome editing based on gene editing nucleases with specific emphasis of CRISPR/Cas9.
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21
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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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24
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Griffin B, Bushby PA, McCobb E, White SC, Rigdon-Brestle YK, Appel LD, Makolinski KV, Wilford CL, Bohling MW, Eddlestone SM, Farrell KA, Ferguson N, Harrison K, Howe LM, Isaza NM, Levy JK, Looney A, Moyer MR, Robertson SA, Tyson K. The Association of Shelter Veterinarians' 2016 Veterinary Medical Care Guidelines for Spay-Neuter Programs. J Am Vet Med Assoc 2017; 249:165-88. [PMID: 27379593 DOI: 10.2460/javma.249.2.165] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
As community efforts to reduce the overpopulation and euthanasia of unwanted and unowned cats and dogs have increased, many veterinarians have increasingly focused their clinical efforts on the provision of spay-neuter services. Because of the wide range of geographic and demographic needs, a wide variety of spay-neuter programs have been developed to increase delivery of services to targeted populations of animals, including stationary and mobile clinics, MASH-style operations, shelter services, community cat programs, and services provided through private practitioners. In an effort to promote consistent, high-quality care across the broad range of these programs, the Association of Shelter Veterinarians convened a task force of veterinarians to develop veterinary medical care guidelines for spay-neuter programs. These guidelines consist of recommendations for general patient care and clinical procedures, preoperative care, anesthetic management, surgical procedures, postoperative care, and operations management. They were based on current principles of anesthesiology, critical care medicine, infection control, and surgical practice, as determined from published evidence and expert opinion. They represent acceptable practices that are attainable in spay-neuter programs regardless of location, facility, or type of program. The Association of Shelter Veterinarians envisions that these guidelines will be used by the profession to maintain consistent veterinary medical care in all settings where spay-neuter services are provided and to promote these services as a means of reducing sheltering and euthanasia of cats and dogs.
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26
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Abstract
This article summarizes the available information on different soft tissue surgical procedures in rabbits, based on the literature and the authors' experiences, emphasizing the differences between rabbits and the more familiar dogs and cats. The major surgical principles in rabbits are discussed, and common surgical procedures, such as abdominal exploration, gastrotomy, enterotomy, liver lobectomy, nephrectomy, cystotomy, cystectomy, ovariohysterectomy, ovariectomy, orchidectomy, are described.
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Affiliation(s)
- Zoltan Szabo
- Tai Wai Small Animal and Exotic Hospital, 75 Chik Shun Street, Tai Wai, Shatin, New Territories, Hong Kong, China.
| | - Katriona Bradley
- Tai Wai Small Animal and Exotic Hospital, 75 Chik Shun Street, Tai Wai, Shatin, New Territories, Hong Kong, China
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27
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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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Uzun M, Kiraz HA, Ovali MA, Sahin H, Erbas M, Toman H. The investigation of airway management capacity of v-gel and cobra-PLA in anaesthetised rabbits. Acta Cir Bras 2015; 30:80-6. [DOI: 10.1590/s0102-86502015001000011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 12/15/2014] [Indexed: 11/22/2022] Open
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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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Benato L, Chesnel M, Eatwell K, Meredith A. Arterial blood gas parameters in pet rabbits anaesthetized using a combination of fentanyl-fluanisone-midazolam-isoflurane. J Small Anim Pract 2013; 54:343-6. [DOI: 10.1111/jsap.12081] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- L. Benato
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, Division of Veterinary Clinical Sciences; The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre; Roslin Midlothian EH25 9RG Scotland
| | - M. Chesnel
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, Division of Veterinary Clinical Sciences; The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre; Roslin Midlothian EH25 9RG Scotland
| | - K. Eatwell
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, Division of Veterinary Clinical Sciences; The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre; Roslin Midlothian EH25 9RG Scotland
| | - A. Meredith
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, Division of Veterinary Clinical Sciences; The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre; Roslin Midlothian EH25 9RG Scotland
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van Oostrom H, Krauss MW, Sap R. A comparison between the v-gel supraglottic airway device and the cuffed endotracheal tube for airway management in spontaneously breathing cats during isoflurane anaesthesia. Vet Anaesth Analg 2013; 40:265-71. [DOI: 10.1111/vaa.12015] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Accepted: 09/13/2012] [Indexed: 11/29/2022]
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Cheong SH, Lee JH, Kim MH, Cho KR, Lim SH, Lee KM, Park MY, Yang YI, Kim DK, Choi CS. Airway management using a supraglottic airway device without endotracheal intubation for positive ventilation of anaesthetized rats. Lab Anim 2013; 47:89-93. [PMID: 23492512 DOI: 10.1177/0023677212473919] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Endotracheal intubation is often necessary for positive pressure ventilation of rats during open thoracic surgery. Since endotracheal intubation in rats is technically difficult and is associated with numerous complications, many techniques using various devices have been described in the scientific literature. In this study, we compared the effectiveness of airway management of a home-made supraglottic airway device (SAD), which is cheap to fabricate and easy to place with that of an endotracheal intubation tube in enflurane-anaesthetized rats. Twenty male Sprague-Dawley rats (200-300 g) were randomly assigned to two equal groups for positive pressure mechanical ventilation using either the SAD or an endotracheal intubation tube. The carotid artery of each rat was cannulated for continuous blood pressure measurements and obtaining blood samples for determination of oxygen tension, carbon dioxide tension, and blood acidity before, during and after SAD placement or endotracheal intubation. Proper placement of the SAD was confirmed by observing chest wall movements that coincided with the operation of the mechanical ventilator. No complications and adverse events were encountered in the rats in which the SAD was placed, during SAD placement and immediate removal, during their mechanical ventilation through the SAD, and one week after SAD removal. From the results of blood gas analyses, we conclude that anaesthetized rats can be successfully ventilated using an SAD for open thoracic surgery.
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Affiliation(s)
- S H Cheong
- Department of Anesthesiology, Paik Hospital, Inje University, Gaegumdong, Jingu, Busan, Korea
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Comparison of laryngeal mask airway use with endotracheal intubation during anesthesia of western lowland gorillas (Gorilla gorilla gorilla). J Zoo Wildl Med 2013; 43:759-67. [PMID: 23272342 DOI: 10.1638/2011-0081r.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The laryngeal mask airway is an alternative to endotracheal intubation that achieves control of the airway by creating a seal around the larynx with an inflatable cuff. This study compared use of the laryngeal mask airway with endotracheal intubation in anesthetized western lowland gorillas (Gorilla gorilla gorilla). Eight adult gorillas were immobilized for routine and diagnostic purposes for a total of nine anesthetic events. During each anesthetic event, gorillas were either intubated (n = 4; group A) or fitted with a laryngeal mask airway (n= 5; group B). Time required to place each airway device, physiologic parameters, and arterial blood gas were measured and compared between the two groups. There were no significant differences between the two groups for time required to place airway device, heart rate, hemoglobin oxygen saturation, end-tidal carbon dioxide, arterial partial pressure of carbon dioxide, or arterial pH between the two groups. Mean arterial partial pressure of oxygen was significantly greater in group B, 15 (group A: 94 +/- 44 mm Hg; group B: 408 +/- 36 mm Hg; P= 0.0025) and 45 (group A: 104 +/- 21 mm Hg; group B: 407 +/- 77 mm Hg; P = 0.0026) min after airway device placement. Mean respiratory rate was significantly greater in group A at multiple time points. Mean arterial pressure (group A: 129 +/- 16 mm Hg; group B: 60 +/- 8 mm Hg) and diastolic blood pressure (group A: 115 +/- 21 mm Hg; group B: 36 +/- 10 mm Hg) were significantly greater in group A at the time of airway device placement. The laryngeal mask airway maintained oxygenation and ventilation effectively in all gorillas and is a useful alternative to endotracheal intubation in western lowland gorillas.
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Falcão SC, Pereira Junior JR, Coelho ARDB. Technique of blind tracheal intubation in rabbits (Oryctolagus cuniculi) supported by previous maneuver of esophageal cannulization. Acta Cir Bras 2011; 26:352-6. [DOI: 10.1590/s0102-86502011000500005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Accepted: 04/25/2011] [Indexed: 11/22/2022] Open
Abstract
PURPOSE: To describe and evaluate a modified technique of blind orotraqueal intubation in rabbits, by supporting of previous cannulization of the esophagus. METHODS: Twelve New Zealand rabbits, weighing between 2,780 a 4,140 kg were anesthetized with xilazine (3mg/Kg) and ketamine (20mg/Kg). The animals were positioned in ventral decubitus with the head hyperextend. With one of the hands the anesthetist with the index and thumb fingers positioned in the labial fissures carry on the opening of animal oral cavity. The esophagus was previously cannulized with a tube # 3.5 (3.5mm ID), obstructing its lumen. The trachea lumen was intubated with a probe # 2.5 (2.5mm ID). The positioning of the probe was confirmed through the oscillatory movement of a gauze filament put at outside extremity of tube, resulting from the inspiratory and expiratory flow. RESULTS: The success index was of 100%. CONCLUSIONS: This technique is of easy execution, high success index, sparing the use of several devices for visualization of the larynx and glottis. No complications were observed. It also serves for short period training of human resources.
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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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Cruz FSF, Carregaro AB, Raiser AG, Zimmerman M, Lukarsewski R, Steffen RPB. Total intravenous anesthesia with propofol and S(+)-ketamine in rabbits. Vet Anaesth Analg 2010; 37:116-22. [DOI: 10.1111/j.1467-2995.2009.00513.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wiederstein I, Moens YPS. Guidelines and criteria for the placement of laryngeal mask airways in dogs. Vet Anaesth Analg 2008; 35:374-82. [PMID: 18466166 DOI: 10.1111/j.1467-2995.2008.00398.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Iris Wiederstein
- Clinic of Anaesthesiology and Perioperative Intensive Care, Department of Companion Animals and Horses, University of Veterinary Medicine Vienna, Veterinärplatz 1, Vienna, Austria.
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Birkholz T, Irouschek A, Kessler P, Blunk JA, Labahn D, Schmidt J. Feasibility of the laryngeal tube airway for artificial ventilation in pigs and comparison with the laryngeal mask airway. Lab Anim (NY) 2008; 37:371-9. [PMID: 18650825 DOI: 10.1038/laban0808-371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2008] [Accepted: 04/23/2008] [Indexed: 11/09/2022]
Abstract
Airway management in anesthetized pigs is known to be technically demanding, and the 'gold standard' technique of endotracheal intubation is particularly difficult to master. The authors investigated the feasibility of the laryngeal tube as an alternative technique for airway management in German Landrace pigs (n = 5). They compared this method with the laryngeal mask, which is considered to be an effective yet relatively straightforward tool for porcine airway management. One after the other, investigators attempted to establish an airway in each anesthetized, artificially ventilated pig using each device. The laryngeal tube was too short to intubate the largest pig (weighing 45 kg), and it took investigators slightly longer to insert this device compared with the laryngeal mask. With the laryngeal mask, there were several incidents of gastric insufflation. Despite these complications, all investigators were able to establish a secure airway and maintain oxygenation with the laryngeal tube, and all subjectively rated both devices as easy to use.
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Affiliation(s)
- Torsten Birkholz
- Department of Anaesthesiology, University Hospital, University of Erlangen-Nuremberg, Erlangen, Germany.
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Kheirabadi BS, Crissey JM, Deguzman R, Holcomb JB. In vivo bleeding time and in vitro thrombelastography measurements are better indicators of dilutional hypothermic coagulopathy than prothrombin time. ACTA ACUST UNITED AC 2007; 62:1352-9; discussion 1359-61. [PMID: 17563647 DOI: 10.1097/ta.0b013e318047b805] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The coagulopathy of trauma is generally confirmed by prothrombin time (PT) > or =16 seconds or an international normalized ratio > or =1.5. However, the utility of these values as a screening test is unknown. We examined different coagulation tests to determine the best predictor of coagulopathic bleeding and mortality in a small animal hemorrhage model. METHODS Coagulopathy was induced in male New Zealand White rabbits by warfarin (W; 2 mg/kg for 2 days; n = 7), or hemodilution and hypothermia (HH; 50% blood exchange with Hextend, 34.5 +/- 0.3 degrees C; n = 7). Normal (N) rabbits without pretreatment served as the control (n = 7). Blood samples collected after coagulopathy induction and analyzed by prothrombin time (PT), activated partial thromboplastin time (aPTT), and thromboelastography (TEG) tests. Liver bleeding time (BT) was also measured before injury. An uncontrolled hemorrhage was created by a longitudinal splenic incision and the abdomen was closed. Rabbits were resuscitated with Hextend solution (25 mL/kg) to return blood pressure to baseline and monitored for 2 hours or until death at which time blood loss was measured. RESULTS Warfarin-induced coagulopathy increased BT, PT, and aPTT. TEG showed increased reaction (R) and clot formation (K) times and marked decrease in clotting rate (alpha angle and Vmax). Hemodilution hypothermia coagulopathy increased only BT and aPTT, and decreased the clotting rate (alpha angle and Vmax) and strength of the clot. After injury, blood losses were higher in coagulopathic rabbits (W = 54.6 +/- 4.2 and HH = 51.1 +/- 8.9 mL/kg) than in normal rabbits (30.6 +/- 12.4 mL/kg) and resulted in 86%, 100%, and 0% death, respectively. BT and Vmax consistently predicted coagulopathic bleeding and death in all animals. CONCLUSION Although satisfactory in warfarin-induced coagulopathy, PT was not a valid screening test for dilutional and hypothermic coagulopathy. BT and TEG measurements of blood clotting rate are better indicators of coagulopathic bleeding and mortality in this lethal hemorrhage model.
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Affiliation(s)
- Bijan S Kheirabadi
- US Army Institute of Surgical Research, Fort Sam, Houston, Texas 78234-6315, USA.
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Fulkerson PJ, Gustafson SB. Use of laryngeal mask airway compared to endotracheal tube with positive-pressure ventilation in anesthetized swine. Vet Anaesth Analg 2007; 34:284-8. [PMID: 17490468 DOI: 10.1111/j.1467-2995.2006.00329.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare the ease of placement and ventilatory parameters of a laryngeal mask airway (LMA) with an endotracheal tube (ETT) in anesthetized swine during positive-pressure ventilation (PPV). STUDY DESIGN Prospective, randomized, experimental trial. ANIMALS Nine young domestic swine, weighing between 40 and 49 kg (mean 45.1 kg), being used for a separate terminal surgical study. METHODS The pigs were immobilized with tiletamine/zolazepam, 2.7-3.6 mg kg(-1), intramuscularly, followed by isoflurane in oxygen delivered by facemask. The lungs were mechanically ventilated through an ETT or an LMA, in random order, during the anesthetic period. Positive-pressure ventilation was adjusted to maintain end-tidal CO2 (Pe'CO2) between 35 and 45 mmHg, with peak inspiratory pressure (P(insp)) of 15-23 cmH2O. Buprenorphine, 0.3 mg intramuscularly, was given to each pig after instrumentation. Isoflurane vaporizer settings were adjusted to maintain a surgical plane of anesthesia. Respiratory rate (RR), tidal volume (V(T)), minute volume (V(E)), and Pe'CO2 were measured and recorded at 5-minute intervals. After the collection of 1 hour of data, the alternate airway was placed. Swine were given at least 30 minutes to stabilize and another hour of data were recorded. At the time of airway placement, the ease of placement was assessed based on time and the number of personnel required. Data were analyzed using paired Student's t-test or Wilcoxon signed rank test where appropriate. RESULTS Laryngeal mask airways were significantly easier to place than ETT. Values for V(T) and V(E) were not significantly different between treatments. Peak inspiratory pressures were higher in ETT-ventilated swine. CONCLUSIONS AND CLINICAL RELEVANCE An LMA may be used as an alternative to an ETT in mechanically-ventilated anesthetized swine. Use of an LMA may reduce time and personnel required for placement of an airway.
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Affiliation(s)
- Pamela J Fulkerson
- Magruder Hall, College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, USA.
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Kazakos GM, Anagnostou T, Savvas I, Raptopoulos D, Psalla D, Kazakou IM. Use of the laryngeal mask airway in rabbits: placement and efficacy. Lab Anim (NY) 2007; 36:29-34. [PMID: 17380146 DOI: 10.1038/laban0407-29] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2006] [Accepted: 11/21/2006] [Indexed: 11/08/2022]
Abstract
The laryngeal mask airway (LMA) has been used in various animal species anesthetized for the purpose of device evaluation, but the device has not been evaluated in rabbits during surgery. The authors tested the feasibility and potential advantages of using the LMA in 50 rabbits undergoing surgery under spontaneous-breathing inhalational anesthesia, focusing mainly on the technique of insertion and its efficacy. The LMA was easily inserted and no air leakage at the larynx was detected. Although four rabbits developed lingual cyanosis, this was reversible and most likely due to lingual vascular compression by the LMA. The authors conclude that the LMA is an attractive alternative to endotracheal intubation, as the mask can be inserted easily and rapidly and its correct placement is easily confirmed.
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Affiliation(s)
- George M Kazakos
- Companion Animal Clinic, Faculty of Veterinary Medicine, Aristotle University of Thessaloniki, Greece.
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Wiederstein I, Auer U, Moens Y. Laryngeal mask airway insertion requires less propofol than endotracheal intubation in dogs. Vet Anaesth Analg 2006; 33:201-6. [PMID: 16764583 DOI: 10.1111/j.1467-2995.2005.00254.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare the doses of propofol required for insertion of the laryngeal mask airway (LMA) with those for endotracheal intubation in sedated dogs. STUDY DESIGN Randomized prospective clinical study. Animals Sixty healthy dogs aged 0.33-8.5 (3.0 +/- 2.3, mean +/- SD) years, weighing 2.2-59.0 (23.4 +/- 13.6, mean +/- SD) kg, presented for elective surgery requiring inhalation anaesthesia. METHODS Animals were randomly assigned to receive either a LMA or an endotracheal tube. Pre-anaesthetic medication was intravenous (IV) glycopyrrolate (0.01 mg kg(-1)) medetomidine (10 microg kg(-1)) and butorphanol (0.2 mg kg(-1)). Repeated IV propofol injections (1 mg kg(-1) in 30 seconds) were given until LMA insertion or endotracheal intubation was achieved, when the presence or absence of laryngospasm, the respiratory rate (fr) and the total dose of propofol used were recorded. RESULTS The total propofol dose (mean +/- SD) required for LMA insertion (0.53 +/- 0.51 mg kg(-1)) was significantly lower than for endotracheal intubation (1.43 +/- 0.57 mg kg(-1)). The LMA could be inserted without propofol in 47% of dogs; the remainder needed a single 1 mg kg(-1) bolus (n = 30). Endotracheal intubation was possible without propofol in 3.3% of the dogs, 47% needed one bolus and 50% required two injections (n = 30). The f(r) (mean +/- SD) was 18 +/- 6 and 15 +/- 7 minute(-1) after LMA insertion and intubation, respectively. CONCLUSION AND CLINICAL RELEVANCE Laryngeal mask airway insertion requires less propofol than endotracheal intubation in sedated dogs therefore propofol-induced cardiorespiratory depression is likely to be less severe. The LMA is well tolerated and offers a less invasive means of securing the upper airway.
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Affiliation(s)
- Iris Wiederstein
- Department of Companion Animals and Horses, Clinic for Anaesthesiology and Perioperative Intensive Care, University of Veterinary Medicine Vienna, Vienna, Austria.
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Abstract
Rabbits are popular companion animals that present to veterinary clinics for routine and emergency care. Clinics equipped for treat-ing dogs and cats may be easily adapted to accommodate rabbits. This article reviews common procedures performed by the clinician specific to rabbits. Topics include handling and restraint, triage and patient assessment, sample collection, and supportive care techniques. Miscellaneous procedures, including anesthetic delivery, nasolacrimal duct flushing, and ear cleaning, are also discussed.
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Affiliation(s)
- Jennifer Graham
- Department of Comparative Medicine, University of Washington, Box 357190 Seattle, WA 98195, USA.
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