Dataset Information

Comparison of a Supraglottic Airway Device (v-gel^®) with Blind Orotracheal Intubation in Rabbits.

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.

SUBMITTER: Engbers S

PROVIDER: S-EPMC5385366 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Publications

Comparison of a Supraglottic Airway Device (v-gel<sup>®</sup>) with Blind Orotracheal Intubation in Rabbits.

Engbers Sarah S Larkin Amy A Rousset Nicolas N Prebble Melanie M Jonnalagadda Mahesh M Knight Cameron G CG Pang Daniel S J DSJ

Frontiers in veterinary science 20170410

<h4>Introduction</h4>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.<h4>Animals and methods</h4>Fifteen adult New Zealand white rabbits were randomized to SGAD or orotracheal intubation (ETT). All animals were sedated with dexmedetomidine (0.1 mg ...[more]

PMID: 28443290

Similar Datasets

Project description:Background: General anesthesia in rabbits is associated with higher morbidity and mortality relative to other mammalian species commonly anesthetized. Unique challenges related to endotracheal intubation (ETI) in rabbits contribute to this risk. Objective: To improve the safety of ETI in rabbits, we developed two new ETI methods using a supraglottic airway device (v-gel®) to facilitate ETI and compared them to traditional "blind" technique. We hypothesized that relative to blind ETI, v-gel® guided ETI provides more successful placement of the endotracheal tube (ETT) in a shorter time. Outcomes included number of intubation attempts, time for achievement of ETI, endoscopic findings, and serial arterial blood gas (ABG) analysis. Study Design: Prospective, randomized, and crossover study. Methods: Ten female, New Zealand White rabbits aged 1-2 years old, weighing 4.3 ± 0.4 kg, were anesthetized four times. Each time, ETI was performed with one of the following techniques: Method 1: v-gel® guided, polypropylene catheter facilitated, intubation using a cuffed ETT; Method 2: v-gel® guided intubation using an uncuffed ETT directly inserted through the device airway channel; Method 3 and 4: Blind intubation with uncuffed or cuffed ETT. Upper airway endoscopy was performed before intubation attempts and after extubation. Serial ABG analysis was performed during the peri-intubation process. Results: V-gel® guided techniques allowed successful ETI on the initial attempt for 9/10 subjects using Method 1 and 10/10 using Method 2. Relative to the v-gel® guided techniques, the blind techniques required more intubation attempts. A median of 2 attempts (range 1-4, p < 0.007) were required for the uncuffed ETT, and a median of 4 (range 1-4, p < 0.001) attempts were performed for the cuffed ETT. The time to perform successful ETI was positively correlated with the number of attempts (ρ = 0.82), while successful ETI was negatively correlated with number of attempts (ρ = -0.82). Endoscopic findings showed mild to moderate laryngeal trauma. In the absence of oxygen supplementation, ABG analysis demonstrated low PaO2, while PaCO2 remained consistent. Conclusions: Facilitated ETI using the v-gel® guided techniques allows for the rapid establishment of a secure airway to provide ventilatory support for rabbits undergoing general anesthesia.

Project description:Background and Objectives: Difficult intubation, which may be encountered unexpectedly during anesthesia, can increase patients' morbidity and mortality. The McGRATH video laryngoscope is known to provide improved laryngeal visibility in patients with difficult or normal airways. The purpose of this study was to evaluate the efficacy of the McGRATH video laryngoscope for orotracheal intubation compared with that of conventional Macintosh laryngoscopes in simulated difficult airway scenarios. Materials and Methods: In this randomized controlled trial, patients who were scheduled for surgery under general anesthesia requiring orotracheal intubation were assigned to the Macintosh laryngoscope (n = 50) or McGRATH video laryngoscope (n = 45) groups. In this study, to create a simulated difficult airway condition, the subjects performed manual in-line stabilization and applied a soft cervical collar. The primary outcome was the rate of successful intubation within 30 s. The time required for an intubation, glottis grade, intubation difficulty scale (IDS score), the subjective ease of intubation, and optimal external laryngeal manipulation (OLEM) were evaluated. In addition, complications caused by each blade were investigated. Results: The intubation success rate within 30 s was not significantly different between the two groups (44 (88.0%) vs. 36 (80.0%), p = 0.286). The glottic grade was better in the McGRATH group than in the Macintosh group (p = 0.029), but neither the intubation time (26.3 ± 8.2 s vs. 24.2 ± 5.0 s, p = 0.134) nor the rates of oral bleeding (2 (4.0%) vs. 0 (0.0%)) and tooth injury (0 (0.0%) vs. 1 (2.2%)) were significantly different between the two groups. Conclusions: The use of the McGRATH video laryngoscope did not improve the intubation success rate or shorten the intubation time. However, the McGRATH video laryngoscope provided a better glottis view than the conventional Macintosh laryngoscope in patients with a simulated difficult airway.

Dataset Information

Comparison of a Supraglottic Airway Device (v-gel^®) with Blind Orotracheal Intubation in Rabbits.

Introduction

Animals and methods

Results

Conclusion

Publications

Comparison of a Supraglottic Airway Device (v-gel<sup>®</sup>) with Blind Orotracheal Intubation in Rabbits.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Dataset Information

Comparison of a Supraglottic Airway Device (v-gel®) with Blind Orotracheal Intubation in Rabbits.

Introduction

Animals and methods

Results

Conclusion

Publications

Comparison of a Supraglottic Airway Device (v-gel<sup>®</sup>) with Blind Orotracheal Intubation in Rabbits.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Comparison of a Supraglottic Airway Device (v-gel^®) with Blind Orotracheal Intubation in Rabbits.