Lee Lyon Y, Lee Dongbin, Ryu Hakhyun, Han Janet H, Ko Jungho, Tyler John W
College of Veterinary Medicine, Western University of Health Sciences, Pomona, California, USA.
College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea.
J Am Assoc Lab Anim Sci. 2019 Mar 1;58(2):240-245. doi: 10.30802/AALAS-JAALAS-17-000150. Epub 2019 Jan 9.
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.
由于各种独特的解剖和生理特征，兔子给临床实践中的常规气管插管带来了独特的挑战。许多先前提出的兔子气管插管方法受到多种因素的限制，包括对昂贵设备的需求和高水平的技术专长。我们评估了二氧化碳波形图在协助兔子气管插管方面的有效性。将新西兰白兔分为3组，每组5只动物。在前两组中，分别使用主流（非分流）或旁流（分流）二氧化碳波形图（分别为MC组和SC组）；在第三组（LS组）中，使用带有00号米勒叶片的喉镜来引导气管导管放置。在给药前，通过肌肉注射将氯胺酮（10 mg/kg）、美托咪定（0.1 mg/kg）和咪达唑仑（1 mg/kg）混合在同一注射器中诱导麻醉。插管时间定义为从张开嘴到插管后第一个二氧化碳波形图完成的时间点。在两个二氧化碳波形图组中，所有动物的插管均成功完成，但喉镜检查组中有2只兔子无法插管。使用单因素方差分析比较各组之间的插管时间，并应用事后邦费罗尼检验来分离组间的显著差异。MC组的插管时间（平均值±1标准差）为46.4±12.6秒，SC组为147.2±44.2秒，LS组为385.0±114.1秒，所有组之间的插管时间有显著差异。总之，主流和旁流二氧化碳波形图引导的气管插管技术在兔子中比传统喉镜引导的气管插管更有效、更高效。此外，主流二氧化碳波形图比旁流二氧化碳波形图更受青睐，因为主流二氧化碳波形图导致插管时间明显更短。
