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Clinical evaluation of the v-gel supraglottic airway device in comparison with a classical laryngeal mask and endotracheal intubation in cats during spontaneous and controlled mechanical ventilation


Prasse, Sarah A; Schrack, Johanna; Wenger, Sandra; Mosing, Martina (2016). Clinical evaluation of the v-gel supraglottic airway device in comparison with a classical laryngeal mask and endotracheal intubation in cats during spontaneous and controlled mechanical ventilation. Veterinary Anaesthesia and Analgesia, 43:55-62.

Abstract

Objective To compare airway management during induction of anaesthesia, in spontaneous ventilation and controlled mechanical ventilation (CMV), using a cat-specific supraglottic airway device (the v-gel), a classical laryngeal mask (LM) or an endotracheal tube (ETT). Study design Prospective, randomized clinical trial. Animals Forty-five healthy cats. Methods After premedication, cats were randomly allocated to one of three groups to secure the airway: 1) v-gel; 2) LM; or 3) ETT (cuff pressure: 20 cm H2O). Cats were anaesthetized for elective procedures. The dose of propofol necessary to insert the vgel, LM or ETT, the number of attempts required to achieve insertion and leakage during spontaneous ventilation and CMV at different peak inspiratory pressures (8, 10, 12, 14 and 16 cm H2O) were recorded. Leakage of >20% of tidal volume was considered as a criterion for exclusion. Significance was set at a p-value of <0.05. Results Cats in the v-gel group required a median (range) of 3 mg kg -1 (2–5 mg kg-1) of propofol for successful placement, which was significantly less than the 5 mg kg-1 (3–7 mg kg-1) required for endotracheal intubation (p = 0.005). No significant difference in the total dose of propofol was observed between the v-gel and LM [3 mg kg-1 (2–7 mg kg-1)] groups or the ETT and LM groups. Significantly more cats in the ETT group were excluded for leakage of >20% during CMV at all pressure settings. Conclusions and clinical relevance The v-gel is a practical alternative to the LM and ETT for securing the airway after induction of anaesthesia and for CMV up to 16 cm H2O in healthy cats. The v-gel can be inserted at a more superficial level of anaesthesia than the ETT and showed significantly less leakage during CMV than the ETT.

Abstract

Objective To compare airway management during induction of anaesthesia, in spontaneous ventilation and controlled mechanical ventilation (CMV), using a cat-specific supraglottic airway device (the v-gel), a classical laryngeal mask (LM) or an endotracheal tube (ETT). Study design Prospective, randomized clinical trial. Animals Forty-five healthy cats. Methods After premedication, cats were randomly allocated to one of three groups to secure the airway: 1) v-gel; 2) LM; or 3) ETT (cuff pressure: 20 cm H2O). Cats were anaesthetized for elective procedures. The dose of propofol necessary to insert the vgel, LM or ETT, the number of attempts required to achieve insertion and leakage during spontaneous ventilation and CMV at different peak inspiratory pressures (8, 10, 12, 14 and 16 cm H2O) were recorded. Leakage of >20% of tidal volume was considered as a criterion for exclusion. Significance was set at a p-value of <0.05. Results Cats in the v-gel group required a median (range) of 3 mg kg -1 (2–5 mg kg-1) of propofol for successful placement, which was significantly less than the 5 mg kg-1 (3–7 mg kg-1) required for endotracheal intubation (p = 0.005). No significant difference in the total dose of propofol was observed between the v-gel and LM [3 mg kg-1 (2–7 mg kg-1)] groups or the ETT and LM groups. Significantly more cats in the ETT group were excluded for leakage of >20% during CMV at all pressure settings. Conclusions and clinical relevance The v-gel is a practical alternative to the LM and ETT for securing the airway after induction of anaesthesia and for CMV up to 16 cm H2O in healthy cats. The v-gel can be inserted at a more superficial level of anaesthesia than the ETT and showed significantly less leakage during CMV than the ETT.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:05 Vetsuisse Faculty > Veterinary Clinic > Equine Department
05 Vetsuisse Faculty > Veterinary Clinic > Department of Small Animals
Dewey Decimal Classification:570 Life sciences; biology
630 Agriculture
Language:English
Date:2016
Deposited On:07 Jan 2016 09:48
Last Modified:05 Apr 2016 19:49
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:1467-2987
Publisher DOI:https://doi.org/10.1111/vaa.12261
PubMed ID:25819338

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