Assessment of v‐gel supraglottic airway device placement in cats performed by inexperienced veterinary students

Abstract

Endotracheal intubation has been associated with several complications in cats. The v-gel supraglottic airway device (SGAD) has been developed to adapt to the unique oropharynx of the cat and to overcome these complications. Thirty-three cats were randomly assigned to receive an endotracheal tube (ETT group) or a v-gel SGAD (v-gel group) after induction of general anaesthesia. Third year veterinary students without previous clinical experience placed these devices under direct supervision of an anaesthesiologist. Amount of propofol, number of attempts, time required to secure the airway, leakage around the device, signs of upper airway discomfort and food consumption were compared between the two groups. The v-gel group required less propofol (P=0.03), less time (P<0.01) and fewer attempts (P<0.01) to secure the cats' airway. The incidence of leakage was lower for the v-gel group immediately after placement of the device (P<0.01) and 60 minutes after induction of general anaesthesia (P=0.04). Cats that received the v-gel SGAD presented a lower incidence of upper airway discomfort immediately after the device was removed (P=0.03) and recorded a higher food consumption score (P=0.03). The v-gel SGAD is a feasible way to secure the airway of healthy cats when performed by inexperienced personnel.

AAFP Feline Anesthesia Guidelines

“…Studies show that the time to obtain a clinically acceptable capnograph reading was shorter when an SGAD was used compared with an ETT, fewer attempts were needed, and less propofol was required. 90,91 The device is suitable for spontaneous ventilation and for controlled mechanical ventilation up to 16 cmH 2 O 91 . Less airway discomfort and stridor and greater food intake were documented after use of an SGAD compared with an ETT; 90 this may be because the device does not enter the trachea (Figure 18).…”

“…90,91 The device is suitable for spontaneous ventilation and for controlled mechanical ventilation up to 16 cmH 2 O 91 . Less airway discomfort and stridor and greater food intake were documented after use of an SGAD compared with an ETT; 90 this may be because the device does not enter the trachea (Figure 18).…”

Success of placement and complications during v-gel placement and maintenance of anaesthesia

“…When performed by inexperienced personnel, it is easier to adequately place the v-gel laryngeal mask than to perform endotracheal intubation. 10 Recumbency during the insertion of the v-gel significantly influenced the correct placement. 10 In the present study, no difference in failure to place the v-gel successfully was observed between the different body positions during placement.…”

“…9 Feline-specific laryngeal mask airway devices have been developed and are now marketed for use in cats under the brand v-gel (Docsinnovent). 10,11 This supraglottic airway device has been specifically designed according to the anatomical situation of the feline larynx. It consists of a non-inflatable cuff that forms a seal around the laryngeal inlet and an inflatable dorsal pressure adjuster to increase seal pressure.…”

Aspiration of a portion of endotracheal tube following patient bite upon recovery from general anaesthesia in a dog

“…Most commonly, the aim of airway protection is achieved via endotracheal intubation, although supraglottic airway devices can also be used and may have some advantages in certain cases 14 . An ETT was chosen in the case described as there were no contraindications of using a standard ETT, they are less prone to dislodgement than supraglottic airway devices, 15 and supraglottic airway devices offer less protection against potential aspiration, although cuffed ETTs are not infallible in this regard. Other reasons for intubation under general anaesthesia include the ability to provide controlled delivery of volatile agent and oxygen to the lungs and to minimise environmental contamination and hence occupational exposure to inhalational anaesthetic agents.…”