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

Abstract

Objectives Airway management during anaesthesia in cats is always a demanding task and is associated with several complications. The aim of this study was to evaluate the practicability and complications during feline-specific laryngeal mask placement in anaesthetised cats as an alternative to endotracheal intubation. Methods In this prospective clinical study, laryngeal masks were placed in 148 anaesthetised cats. Success of placement was evaluated by capnography. Results Placement was possible at the first attempt in 136 cats, at the second attempt in eight cats and at the third attempt in one cat. In one cat, placement was not possible. Two cats were excluded. Failure to position the laryngeal mask at the first attempt was not different between laryngeal mask sizes ( P = 0.313) or positioning during placement ( P = 0.406). In nine cats, the laryngeal mask dislocated during the procedure. Dislocation occurred more often in the dorsal position than in the sternal ( P = 0.018) and right lateral positions ( P = 0.046). Mucous obstruction of the laryngeal mask occurred in one of these cats and regurgitation in another. Material-related issues, such as disconnection of the parts of the laryngeal mask and leakage of the balloon, were observed in 2/8 laryngeal masks. Conclusions and relevance The placement of a feline-specific laryngeal mask was easy to perform. In about 7% of the cases, replacement of the device was required due to mispositioning or dislocation. Full monitoring, including capnography, should be provided to uncover dislocation and airway obstruction immediately.

Comparative study of ventilation techniques with supraglottic airway devices in cats: volume-controlled vs pressure-controlled techniques

“…A recent study in cats showed that while placement of the SGAD was easy to execute, approximately 7% of cases required device replacement due to mispositioning or dislocation. 12 A laryngeal mask airway (LMA), which is one type of SGAD, can be effectively utilised for mechanical ventilation in humans with normal airway resistance and compliance. 13 Comparisons have been made between the application of an SGAD and ETT in cats, employing either pressure-controlled ventilation (PCV) or volume-controlled ventilation (VCV).…”

Computational fluid dynamics comparison of the upper airway velocity, pressure, and resistance in cats using an endotracheal tube or a supraglottic airway device

“…Alternatively, a laryngeal mask or supraglottic airway device (SGAD) has been developed for airway management during anesthesia. These devices seal the upper airways above the rima glottidis and are associated with an increased risk of gastro-esophageal reflux and possible aspiration in human ( 2 ) and veterinary patients ( 6 ). They were first developed for humans ( 7 ) and then for rabbits and cats ( 6 , 8 , 9 ).…”

“…These devices seal the upper airways above the rima glottidis and are associated with an increased risk of gastro-esophageal reflux and possible aspiration in human ( 2 ) and veterinary patients ( 6 ). They were first developed for humans ( 7 ) and then for rabbits and cats ( 6 , 8 , 9 ). The SGAD used in cats is positioned above the rima glottidis, seal the esophageal entrance, and an inflatable dorsal adjuster that can increase seal pressure allowing spontaneous or mechanical ventilation ( 9 ).…”

“…The SGAD used in cats is positioned above the rima glottidis, seal the esophageal entrance, and an inflatable dorsal adjuster that can increase seal pressure allowing spontaneous or mechanical ventilation ( 9 ). Insertion problems have been described, including multiple attempts to correct placement, dislodgement, coughing during insertion, causing upper airway obstruction, stimulus for regurgitation and vomiting ( 3 , 6 ) and fresh gas flow leakages during mechanical ventilation ( 3 ).…”