Laryngeal mask airway insertion requires less propofol than endotracheal intubation in dogs

OBJECTIVE: To compare the doses of propofol required for insertion of the laryngeal mask airway (LMA) with those for endotracheal intubation in sedated dogs. STUDY DESIGN: Randomized prospective clinical study. Animals Sixty healthy dogs aged 0.33-8.5 (3.0 +/- 2.3, mean +/- SD) years, weighing 2.2-59.0 (23.4 +/- 13.6, mean +/- SD) kg, presented for elective surgery requiring inhalation anaesthesia. METHODS: Animals were randomly assigned to receive either a LMA or an endotracheal tube. Pre-anaesthetic medication was intravenous (IV) glycopyrrolate (0.01 mg kg(-1)) medetomidine (10 microg kg(-1)) and butorphanol (0.2 mg kg(-1)). Repeated IV propofol injections (1 mg kg(-1) in 30 seconds) were given until LMA insertion or endotracheal intubation was achieved, when the presence or absence of laryngospasm, the respiratory rate (fr) and the total dose of propofol used were recorded. RESULTS: The total propofol dose (mean +/- SD) required for LMA insertion (0.53 +/- 0.51 mg kg(-1)) was significantly lower than for endotracheal intubation (1.43 +/- 0.57 mg kg(-1)). The LMA could be inserted without propofol in 47% of dogs; the remainder needed a single 1 mg kg(-1) bolus (n = 30). Endotracheal intubation was possible without propofol in 3.3% of the dogs, 47% needed one bolus and 50% required two injections (n = 30). The f(r) (mean +/- SD) was 18 +/- 6 and 15 +/- 7 minute(-1) after LMA insertion and intubation, respectively. CONCLUSION AND CLINICAL RELEVANCE: Laryngeal mask airway insertion requires less propofol than endotracheal intubation in sedated dogs therefore propofol-induced cardiorespiratory depression is likely to be less severe. The LMA is well tolerated and offers a less invasive means of securing the upper airway.     

Propofol versus thiopental: effects on peri-induction intraocular pressures in normal dogs

ObjectiveTo determine the effects of propofol or thiopental induction on intraocular pressures (IOP) in normal dogs.Study designProspective randomized experimental study.AnimalsTwenty-two random-source dogs weighing 19.5 ± 5.3 kg.MethodsDogs were randomly assigned to receive propofol 8 mg kg⁻¹ IV (group P) or thiopental 18 mg kg⁻¹ IV (group T) until loss of jaw tone. Direct arterial blood pressure, arterial blood gasses, and IOP were measured at baseline, after pre-oxygenation but before induction, before endotracheal intubation, and after intubation.ResultsThere were no significant differences between groups with regard to weight, body condition score, breed group, or baseline or before-induction IOP, arterial blood pressure, or blood gases. The baseline IOP was 12.9 mmHg. Before endotracheal intubation, IOP was significantly higher compared to baseline and before induction in dogs receiving propofol. After intubation with propofol, IOP was significantly higher compared to thiopental and was significantly higher compared to before induction. After intubation, IOP was significantly lower compared to before intubation in dogs receiving thiopental. Propofol increased IOP before intubation by 26% over the before-induction score and thiopental increased IOP by 6% at the same interval. The IOP in group P remained 24% over the before induction score whereas thiopental ultimately decreased IOP 9% below baseline after intubation. There was no significant relationship between any cardiovascular or blood gas parameter and IOP at any time. There was no significant relationship between the changes in any cardiovascular or blood gas parameter and the changes in IOP between time points.Conclusions and clinical relevancePropofol caused a significant increase in IOP compared to baseline and thiopental. Thiopental caused an insignificant increase in IOP which decreased after intubation. Propofol should be avoided when possible in induction of anesthesia in animals where a moderate increase in IOP could be harmful.     

The effect of user experience and inflation technique on endotracheal tube cuff pressure using a feline airway simulator

Objective

The effect of user experience and inflation technique on endotracheal tube cuff pressure using a feline airway simulator.

Experimental evaluation of four airway devices in anaesthetized New Zealand White rabbits

Objective

To compare airway management during induction of anaesthesia, spontaneous ventilation (SV) and controlled mechanical ventilation (CMV), using an endotracheal tube (ETT), laryngeal mask (LM), rabbit-specific supraglottic airway device (v-gel) or facemask (FM).

latrogenic lipoid pneumonia in an adult horse

A 20-year-old gelding presented with a history of acute respiratory distress which began immediately after administration of a mineral oil and water mix, via nasogastric intubation, for treatment of suspected gastrointestinal dysfunction. An initial presumptive diagnosis of acute lipoid pneumonia was made; this was further supported by evidence of arterial hypoxaemia and oxygen desaturation on arterial blood gas analysis, ultrasonographic signs of bilateral ventral lung consolidation and a mixed bronchoalveolar-interstitial lung pattern seen on thoracic radiographs. Despite intensive supportive therapy the horse's condition continued to deteriorate and the decision was made for humane euthanasia. Gross necropsy findings supported the clinical diagnosis of lipoid pneumonia.     

A low-cost portable simulator of a domestic cat larynx for teaching endotracheal intubation

ObjectiveTo design and construct an affordable simulator of the cat larynx for training intubation maneuvers and to share the designs for its fabrication.Study designResearch and development study.AnimalsA domestic cat.MethodsThe cadaver of a cat, dead by natural causes, was frozen in sternal recumbency with the neck extended and the mouth wide open. A computed tomography image was acquired and used to construct a digital three-dimensional (3D) model of the pharynx and trachea. A digitally adapted model was 3D-printed and used to generate a silicone model of these structures, which was placed within a wooden container. The quality of the simulator was assessed by 46 veterinary anesthesiologists and veterinarians with experience in tracheal intubation maneuvers, and their opinions were obtained through an anonymous questionnaire.ResultsSeveral preliminary prototypes were assessed regarding stability, texture and cost. Finally, a silicone model of a cat larynx (LaryngoCUBE) was produced and encased in a wooden container. Results from the questionnaire showed high scores regarding anatomy, tissue texture and intubation maneuver realism, compared with the real procedure.Conclusionsand clinical relevance Use of LaryngoCUBE as a training tool may improve the skills of students and reduce the use of animals for teaching endotracheal intubation. Blueprints and computational models are provided online so that the simulator can be fully reproduced.     

Tracheal rupture following general anaesthesia in a horse

A Dutch Warmblood, with no other underlying clinical disease, presented for surgical excision of a sarcoid tumour on the distal right pinna under general anaesthesia. At the end of the procedure, immediately before being moved to recovery, the horse became light and made repeated attempts to move whilst attached to the hoist. Anaesthesia was deepened with intravenous thiopental sodium (Thiopentone)¹ and the horse was moved into the recovery room. The trachea was extubated with the cuff of the endotracheal tube inadvertently left partially inflated. Recovery was smooth and the horse stood uneventfully. The following day subcutaneous emphysema was noted along the neck and tracheoscopy revealed an abnormal dorsoventrally flattened trachea and a 5 cm tear in the dorsal aspect of the trachea. Symptomatic treatment resulted in progressive healing of the lesion and the horse recovered fully with no evidence of respiratory complications.