Comparison of a Supraglottic Airway Device (v-gel®) with Blind Orotracheal Intubation in Rabbits

Sarah Engbers, Amy Larkin, Nicolas Rousset, Melanie Prebble, Mahesh Jonnalagadda, Cameron G. Knight, Daniel S. J. Pang

Achieving a secure airway in rabbits is generally considered more difficult than in cats or dogs. Their relatively large tongue, small oropharyngeal cavity and glottis limit direct visualization. A rabbit-specific supraglottic airway device (SGAD) may offer benefits over blind orotracheal intubation. Fifteen adult New Zealand white rabbits were randomized to SGAD or orotracheal intubation (ETT). All animals were sedated with dexmedetomidine (0.1 mg kg(-1) IM) and midazolam (0.5 mg kg(-1) IM), followed by induction with alfaxalone (0.3 mg kg(-1) IV). Two CT scans of the head and neck were performed, following sedation and SGAD/ETT placement. The following were recorded: time to successful device insertion, smallest cross-sectional airway area, airway sealing pressure, and histological score of tracheal tissue. Data were analyzed with a Mann-Whitney test. Two rabbits were excluded following failed ETT. Body masses were similar [ETT; n = 6, 2.6 (2.3-4.5) kg, SGAD; n = 7, 2.7 (2.4-5.0) kg]. SGAD placement was significantly faster [33 (14-38) s] than ETT [59 (29-171) s]. Cross-sectional area (CSA) was significantly reduced from baseline [12.2 (6.9-3.4) mm(2)] but similar between groups [SGAD; 2.7 (2.0-12.3) mm(2), ETT; 3.8 (2.3-6.6) mm(2)]. In the SGAD group, the device tip migrated into the laryngeal vestibule in 6/7 rabbits, reducing the CSA. ETT airway seals were higher [15 (10-20) cmH2O], but not significant [SGAD; 5 (5-20) cmH2O, p = 0.06]. ETT resulted in significantly more mucosal damage [histological score 3.3 (1.0-5.0)], SGAD; 0.67 (0.33-3.67). The SGAD studied was faster to place and caused less damage than orotracheal intubation, but resulted in a similar CSA.