A New Supraglottic Device as Alternative for Rabbit Endotracheal Intubation
American Association of Zoo Veterinarians Conference 2012
Yvonne R.A. van Zeeland, DVM, MVR; Nico J. Schoemaker, DVM, PhD, DECZM (Small Mammal, Avian), DABVP (Avian)
Division of Zoological Medicine, Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands


In rabbits, anesthetic risks are significantly higher than in dogs and cats.2 During prolonged anesthesia, assuring a patent upper airway is vital to increase the chances of survival.2 Currently, the most common method to achieve this is endotracheal intubation.5,8 This method of intubation is complicated by the rabbit’s oropharyngeal anatomy and tendency to develop laryngospasm during intubation.5,8 In addition, post-intubation complications may occur, such as respiratory arrest, laryngeal/tracheal injury or edema, or development of tracheal strictures.4,5,9

Because of the difficulties of intubating rabbits, alternative approaches to manage the airway, such as the use of supraglottic airway devices, have been investigated.1,6,7,10,11 However, the use of such devices to date have primarily involved experimental studies with human pediatric devices or prototypes for use in laboratory animals.1,6,7,10,11 In 2009, a novel supra-glottic airway device (v-gel®, Docsinnovent Ltd, London, UK) was developed with the use of rabbit cadavers.3 After refinement of the prototype, which was designed specifically to fit the rabbit’s oropharyngeal anatomy, clinical trials were performed to validate its use in clinical practice. To date, the v-gel® has been used in >200 rabbits. In >90% patients, a patent airway was established quickly and easily on the first attempt, and successfully maintained during both spontaneous and mechanically controlled ventilation with minimal leakage of isoflurane. Minor complications (e.g., linguocyanosis, gastric inflation, insertion difficulties due to improper anesthetic depth or dental issues) were encountered in <5% of patients. In addition, recovery was usually quick and uneventful. Results demonstrate that the v-gel® provides an attractive and practical alternative to endotracheal intubation in rabbits.

Literature Cited

1.  Bateman, L., J.W. Ludders, R.D. Gleed, and H.D. Erb. 2005. Comparison between facemask and laryngeal mask airway in rabbits during isoflurane anesthesia. Vet. Anaesth. Analg. 32:280–288.

2.  Brodbelt, D.C., K.J. Blissitt, R.A. Hammond, P.J. Neath, L.E. Young, D.U. Pfeiffer, and J.L.N. Wood. 2008. The risk of death: the confidential enquiry into perioperative small animal fatalities. Vet. Anaesth. Analg. 35:365–373.

3.  Crotaz, I. 2010. Initial feasibility investigation of the v-gel airway: an anatomically designed supraglottic airway device for use in companion animal veterinary anaesthesia. Vet. Anaesth. Analg. 37:579–580

4.  Grint, N.J., I.R. Sayers, R. Cecchi, R. Harley, and M.J. Day. 2006. Postanaesthetic tracheal strictures in three rabbits. Lab. Anim. 40:301–308.

5.  Hawkins, M.G., and P.J. Pascoe. 2012. Anesthesia, analgesia and sedation of small mammals. In: Quesenberry, K.E., and J. Carpenter (eds.). Ferrets, Rabbits, and Rodents: Clinical Medicine and Surgery, 3rd ed., Saunders, St. Louis, Missouri. Pp. 429–451.

6.  Imai, A., P.H. Eisele, and E.P. Steffey. 2005. A new airway device for small laboratory animals. Lab. Anim. 39:111–115.

7.  Kazakos, G.M., T. Anagnostou, I. Savvas, D. Raptopoulos, D. Psalla, and I.M. Kazakou. 2007. Use of the laryngeal mask airway in rabbits: placement and efficacy. Lab. Anim. 36:29–34.

8.  Lipman, N.S., R.P. Marini, and P.A. Flecknell. 1997. Anesthesia and analgesia in rabbits. In: Kohn, D.F., Wixson, S.K., White, W.J., and G.J. Benson (eds.). Anesthesia and Analgesia in Laboratory Animals. Academic Press, New York, New York. Pp. 205–232.

9.  Phaneuf, L.R., S. Barker, M.A. Groleau, and P.V. Turner. 2006. Tracheal injury after endotracheal intubation and anesthesia in rabbits. J. Am. Assoc. Lab. Anim. Sci. 45:67–72.

10.  Smith, J.C., L.D. Robertson, A. Auhli, T.J. March, C. Derring, and B. Bolon. 2004. Endotracheal tubes versus laryngeal mask airways in rabbit inhalation anesthesia: ease of use and waste gas emissions. Contemp. Top. Lab. Anim. Sci. 43:22–25.

11.  Yamamoto, Y., S. Inoue, R. Abe, M. Kakaguchi, and H. Furuya. 2009. Airway management with the laryngeal tube in rabbits. Lab. Anim. 36:33–35.


Speaker Information
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Yvonne R.A. van Zeeland, DVM, MVR
Division of Zoological Medicine
Department of Clinical Sciences of Companion Animals
Faculty of Veterinary Medicine
Utrecht University
Utrecht, The Netherlands

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