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比较内镜经气管插管和 V-Gel 声门上气道装置在接受卵巢子宫切除术的新西兰白兔中自主通气的效果。

Comparison of endoscopic endotracheal intubation and the v-gel supraglottic airway device for spontaneously ventilating New Zealand white rabbits undergoing ovariohysterectomy.

机构信息

Department of Small Animal Medicine and Surgery (Zoological Medicine), College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA

Department of Small Animal Medicine and Surgery (Zoological Medicine), College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA.

出版信息

Vet Rec. 2020 Nov 14;187(10):e84. doi: 10.1136/vr.105746. Epub 2020 Jul 20.

Abstract

BACKGROUND

Due to the technical difficulties with endotracheal intubation of rabbits, a prospective, randomised, controlled study was performed to compare a rabbit-specific supraglottic airway device (SGAD), the v-gel, with endoscopic endotracheal intubation (EEI) in spontaneously breathing rabbits undergoing ovariohysterectomy.

METHODS

Fourteen adult female New Zealand white rabbits were randomly allocated to one of two groups based on the method of airway establishment: EEI or v-gel SGAD. Anaesthesia was induced with ketamine and xylazine and maintained using isoflurane in 100 per cent oxygen. Comparisons were made between groups based on placement time of endotracheal tube/SGAD, number of attempts and adjustments, the necessity to increase isoflurane concentrations to maintain a surgical plane of anaesthesia, arterial blood gas values, gross laryngeal evaluation, and laryngotracheal histopathology.

RESULTS

Both techniques resulted in elevated arterial pCO levels, but the v-gel was associated with more elevated pCO in comparison with EEI (P=0.045). Airway trauma was histologically present but clinically negligible in both groups, with no statistically significant differences observed between techniques (P>0.05). Placement time of the v-gel was significantly faster (P=0.003) and required less technical skill than EEI, but was more easily displaced when changing the animal's position (P=0.004).

CONCLUSION

The v-gel is a practical alternative to EEI for securing the airway of healthy spontaneously ventilating rabbits, provided a capnograph is utilised to ensure continuous placement. Both airway techniques appear safe and effective with few complications, as long as intermittent positive pressure ventilation can be employed to correct hypercapnia.

摘要

背景

由于对兔进行气管内插管存在技术困难,因此进行了一项前瞻性、随机、对照研究,比较了一种特定于兔的声门上气道装置(SGAD),即 v-gel,与在接受卵巢子宫切除术的自主呼吸兔中进行内镜气管内插管(EEI)。

方法

14 只成年雌性新西兰白兔根据气道建立方法随机分为两组之一:EEI 或 v-gel SGAD。麻醉诱导使用氯胺酮和二甲噻嗪,并用 100%氧气中的异氟烷维持。根据气管内插管/SGAD 的放置时间、尝试和调整次数、需要增加异氟烷浓度以维持手术麻醉平面、动脉血气值、大体喉部评估和喉气管组织病理学进行组间比较。

结果

两种技术均导致动脉 pCO 水平升高,但与 EEI 相比,v-gel 与更高的 pCO 相关(P=0.045)。气道创伤在组织学上存在但临床上可忽略不计,两种技术之间无统计学差异(P>0.05)。v-gel 的放置时间明显更快(P=0.003),所需技术技能少于 EEI,但在改变动物位置时更容易移位(P=0.004)。

结论

v-gel 是健康自主通气兔气道的一种实用替代 EEI 的方法,只要使用呼气末二氧化碳图来确保连续放置即可。只要可以使用间歇正压通气来纠正高碳酸血症,两种气道技术似乎都是安全有效的,并发症很少。

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