Engbers Sarah, Larkin Amy, Rousset Nicolas, Prebble Melanie, Jonnalagadda Mahesh, Knight Cameron G, Pang Daniel S J
Cochrane Veterinary Care Clinic, Cochrane, AB, Canada.
Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
Front Vet Sci. 2017 Apr 10;4:49. doi: 10.3389/fvets.2017.00049. eCollection 2017.
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.
Fifteen adult New Zealand white rabbits were randomized to SGAD or orotracheal intubation (ETT). All animals were sedated with dexmedetomidine (0.1 mg kg IM) and midazolam (0.5 mg kg IM), followed by induction with alfaxalone (0.3 mg kg 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.
Two rabbits were excluded following failed ETT. Body masses were similar [ETT; = 6, 2.6 (2.3-4.5) kg, SGAD; = 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) mm] but similar between groups [SGAD; 2.7 (2.0-12.3) mm, ETT; 3.8 (2.3-6.6) mm]. 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) cmHO], but not significant [SGAD; 5 (5-20) cmHO, = 0.06]. ETT resulted in significantly more mucosal damage [histological score 3.3 (1.0-5.0)], SGAD; 0.67 (0.33-3.67).
The SGAD studied was faster to place and caused less damage than orotracheal intubation, but resulted in a similar CSA.
一般认为,在兔中建立安全气道比在猫或狗中更困难。兔相对较大的舌头、较小的口咽腔和声门限制了直接视野。一种针对兔的声门上气道装置(SGAD)可能比盲目经口气管插管更具优势。
15只成年新西兰白兔被随机分为SGAD组或经口气管插管(ETT)组。所有动物均用右美托咪定(0.1mg/kg,肌肉注射)和咪达唑仑(0.5mg/kg,肌肉注射)镇静,随后用阿法沙龙(0.3mg/kg,静脉注射)诱导。在镇静及放置SGAD/ETT后进行两次头颈部CT扫描。记录以下指标:成功插入装置的时间、最小气道横截面积、气道密封压力以及气管组织的组织学评分。数据采用曼-惠特尼检验进行分析。
2只兔经口气管插管失败后被排除。体重相似[ETT组;n = 6,2.6(2.3 - 4.5)kg,SGAD组;n = 7,2.7(2.4 - 5.0)kg]。放置SGAD的速度明显快于经口气管插管[33(14 - 38)秒],经口气管插管为[59(从29 - 171)秒]。横截面积(CSA)较基线显著减小[12.2(6.9 - 3.4)mm²],但两组间相似[SGAD组;2.7(2.0 - 12.3)mm²,ETT组;3.8(2.3 - 6.6)mm²]。在SGAD组中,7只兔中有6只装置尖端移入喉前庭,减小了CSA。经口气管插管的气道密封压力更高[15(10 - 20)cmH₂O],但差异无统计学意义[SGAD组;5(5 - 20)cmH₂O,P = 0.06]。经口气管插管导致的黏膜损伤明显更多[组织学评分为3.3(1.0 - 5.0)],SGAD组为0.67(0.33 - 3.67)。
所研究的SGAD放置速度更快,与经口气管插管相比造成的损伤更小,但气道横截面积相似。