When using a v-gel in cats , there are reductions in the dose of induction agent required , the number of attempts to place and the time to secure the airway , when compared with the use of ETTs [ 4 , 5 ] . Less induction agent was also required in dogs when human-specific LMAs were placed , before the invention of the v-gel [ 6 ] . A reduction in induction agent dose may be advantageous in avoiding less desirable dose-dependent effects , such as induction apneoa , hypoventilation or hypotension .
There is a lower incidence of stridor and upper airway discomfort and higher food consumption postoperatively in cats that had a v-gel placed , compared with an ETT [ 5 , 7 ] .
Figure 7 . A feline v-gel . Image © Docinnovent Ltd .
There is a 10-step list of criteria to optimise and standardise correct LMA placement . This ensures airway seals are achieved in a variety of dog breeds , both spontaneously and mechanically ventilated .
The steps include no swallowing during insertion , aligning of reference lines to the incisors , normal capnograph appearance and no laryngeal stridor during spontaneous breathing , and no leaks when 10 cm H 2
O
PPV is performed [ 3 ] .
Docsinnovent states that the new v-gel advanced model can be used during most dental procedures . It can be used in spontaneously breathing patients and those requiring PPV , with pressures up to 16 cmH 2
O being successfully reported in cats [ 4 ] . They can be used in brachycephalic patients that do not have laryngeal or tracheal collapse and in those that do not require airway surgery .
However , an SGAD must not be used in patients at risk of vomiting or regurgitation [ 2 ] . The use of a humanspecific LMA was associated with an increased incidence
Table 2 . Types of intubation aids .
Aid type Description Image Laryngoscope
Laryngoscopes help the user see the airway and , used with the correct technique , should not hinder intubation . There are two types of laryngoscope blades : the Macintosh ( curved ) and the Miller ( straight ) ( shown in this table ), both with integrated lights . Veterinary-specific laryngoscopes have a ridge on the left side , for right-handed intubation . However , human-specific laryngoscopes have a ridge on the right side , so they may be preferable for left-handed users .
Stylet
A stylet can be used to add rigidity and shape to an ETT ( e . g . silicone ) for ease of placement . The stylet must never advance past the distal tip of the ETT . Note that the top image shows the stylet out of the end of the tube . The stylet should go through the middle of the tube and should not be passed all the way through .
Bougie
A bougie is a firm , soft-tipped stylet , which can be advanced through the larynx , into the trachea . It has a high-gloss , lowfriction surface , allowing an ETT to be slid over the top , after which it can be removed , leaving the ETT in place . The low point-of-pressure tip of the bougie can be used to feel the tracheal rings , to confirm placement in a patient where the user ’ s sight is obscured , e . g . in a brachycephalic patient .
48 Veterinary Nursing Journal