Does the use of supraglottic device in rabbits cause less injury than other airway management devices?

Published:

2022-12-02

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DOI

https://doi.org/10.18849/ve.v7i4.608

Abstract

PICO question

In rabbits, undergoing general anaesthesia, does the placement of a v-gel® device result in less airway trauma compared to the use of other airway management devices?

 

Clinical bottom line

Category of research question

Treatment

The number and type of study designs reviewed

Three papers were critically appraised, two blinded randomised experimental trial studies and one randomised crossover experimental trial study

Strength of evidence

Weak

Outcomes reported

One blinded randomised trial study demonstrated that the trauma to the upper airways of rabbits during anaesthesia is not significantly different between the use of v-gel® and an endotracheal tube. The other blinded randomised trial study demonstrated that the trauma to the upper airway caused by endotracheal intubation is significantly more than that caused by v-gel® placement. The randomised crossover trial study demonstrated that v-gel® placement causes more significant compression to the larynx compared to a laryngeal mask or face mask

Conclusion

The current evidence suggests that use of the v-gel® in rabbits causes less trauma / injury to the airways compared to placement of an endotracheal tube but not compared to the use of a laryngeal or face mask. However, based on the low number and quality of published studies, this evidence is weak, and better-quality studies are required to support the routine use of v-gel® over other airway devices in rabbits. While v-gel® may be a safer alternative for securing airways in rabbits compared to endotracheal intubation, knowing the injuries this device can cause to the upper airways is useful for managing rabbits during post anaesthesia recovery

 

How to apply this evidence in practice

The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.

Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.

References

Anderson, J. (2013). Chapter II.2.2 – Inflammation, Wound Healing, and the Foreign-Body Response. In: B. Ratner, A. Hoffman, F. Schoen, J. Lemons, ed., Biomaterial Science, 3rd ed. Academic Press, 503–512.

Bateman, L., Ludders, J., Gleed, R. & Erb, H. (2005). Comparison between facemask and laryngeal mask airway in rabbits during isoflurane anesthesia. Veterinary Anaesthesia and Analgesia. 32(5), 280–288. DOI: https://doi.org/10.1111/j.1467-2995.2005.00169.x

Brodbelt, D., Blissitt, K., Hammond, R., Neath, P., Young, L., Pfeiffer, D. & Wood, J. (2008). The risk of death: the Confidential Enquiry into Perioperative Small Animal Fatalities. Veterinary Anaesthesia and Analgesia. 35(5), 365–373. DOI: https://doi.org/10.1111/j.1467-2995.2008.00397.x

Comolli, J., Schnellbacher, R., Beaufrere, H., Blas-Machado, U., Quandt, J., Mayer, J. & Divers, S. (2020). Comparison of endoscopic endotracheal intubation and the v-gel supraglottic airway device for spontaneously ventilating New Zealand white rabbits undergoing ovariohysterectomy. Veterinary Record. 187(10), E84. DOI: https://doi.org/10.1136/vr.105746

Crotaz, I. (2013). An observational clinical study in cats and rabbits of an anatomically designed supraglottic airway device for use in companion animal veterinary anaesthesia. The Veterinary Record. 172(23), 606. DOI: https://doi.org/10.1136/vr.100668

Donnelly, T. & Vella, D. (2020). 11 – Basic Anatomy, Physiology, and Husbandry of Rabbits. In: Quesenberry, C. Orcutt, C. Mans, & J. Carpenter, eds., Ferrets, Rabbits, and Rodents, 4th ed. Philadelphia: W.B. Saunders, 131–149.

Eatwell, K. (2014). Analgesia, sedation and anaesthesia. In: A. Meredith, B. Lord, ed., BSAVA Manual of Rabbit Medicine, 1st ed. England: British Small Animal Veterinary Association, 138–159.

Engbers, S., Larkin, A., Rousset, N., Prebble, M., Jonnalagadda, M., Knight, C. & Pang, D. (2017). Comparison of a supraglottic airway device (v-gel) with blind orotracheal intubation in rabbits. Frontiers in Veterinary Science. 4, 49. DOI: https://doi.org/10.3389/fvets.2017.00049

Goldmann, K. & Ferson, D. (2005). Education and training in airway management. Best Practice & Research Clinical Anaesthesiology. 19(4), 717–732. DOI: https://doi.org/10.1016/j.bpa.2005.07.007

Hawkins, M. & Pascoe, P. (2021). 37 – Anesthesia, Analgesia, and Sedation of Small Mammals. In: Quesenberry, C. Orcutt, C. Mans, & J. Carpenter, eds., Ferrets, Rabbits, and Rodents, 4th ed. Philadelphia: W.B. Saunders, 536–558.

Kazakos, G., Anagnostou, T., Savvas, I., Raptopoulos, D., Psalla, D. & Kazakou, I. (2007). Use of the laryngeal mask airway in rabbits: placement and efficacy. Lab Animal. 36(4), 29–34. DOI: https://doi.org/10.1038/laban0407-29

Mayer, J., Brown, S. & Mitchell, M. (2017). Survey to Investigate Owners׳ Perceptions and Experiences of Pet Rabbit Husbandry and Health. Journal of Exotic Pet Medicine. 26(2), 123–131. DOI: https://doi.org/10.1053/j.jepm.2017.01.021

Wenger, S., Müllhaupt, D., Ohlerth, S., Prasse, S., Klein, K., Da Silva Valente, B. & Mosing, M. (2017). Experimental evaluation of four airway devices in anaesthetized New Zealand White rabbits. Veterinary Anaesthesia and Analgesia. 44(3), 529–537. DOI: https://doi.org/10.1016/j.vaa.2016.05.009

Vol. 7 No. 4 (2022): The fourth issue of 2022

Section: Knowledge Summaries

Categories :  Small Animal  /  Dogs  /  Cats  /  Rabbits  /  Production Animal  /  Cattle  /  Sheep  /  Pig  /  Equine  /