A flexible endotracheal tube introducer improves first-attempt success of intubation in cats by novice anesthetists

Abstract

OBJECTIVE To test whether the use of a flexible endotracheal tube introducer (ETI) facilitates intubation of cats by veterinary students with little or no experience. ANIMALS 125 healthy cats. PROCEDURES Cats were sedated with dexmedetomidine and morphine IM, and anesthesia was induced with propofol. They were randomly assigned to be intubated by supervised veterinary students using an ETI within a tracheal tube or an endotracheal tube alone (3.0, 3.5, or 4.0 internal diameter sizes). Success rate at first attempt, number of attempts to intubate (up to 3), and time to intubate were recorded. Multivariate logistic regression was used to test associations between several factors such as use of an ETI, cat’s weight, endotracheal tube size, administration of ketamine for sedation, and first-attempt success. Significance was considered when P < 0.05. RESULTS Success rate for the first attempt was higher with an ETI (79% [51/64) than without it (46% [28/61]), and attempts to intubate were fewer when an ETI was used (both P < 0.001). Time to intubate did not differ between groups (ETI, 30 seconds [4 to 143 seconds]; endotracheal tube, 28 seconds [5 to 180 seconds]). Use of an ETI was positively associated with improved first-attempt success, and the 3.0-mm internal diameter of the tube was negatively associated (both P ≤ 0.001). CLINICAL RELEVANCE The use of a flexible ETI improved the success of first-attempt intubation of cats by veterinary students. This technique may help minimize the number of attempts during intubation and incidence of complications that could arise from multiple attempts.

Effect of Dexmedetomidine Low Doses with or without Midazolam in Cats: Clinical, Hemodynamic, Blood Gas Analysis, and Echocardiographic Effects

“…The anesthetic plan was kept superficial, through the observation of clinical parameters, such as maintenance of protective reflexes and cardiorespiratory stability. A 22 G [ 1 ] catheter was aseptically introduced into the metatarsal artery to measure invasive blood pressure and to collect 0.5 mL of blood in a syringe with sodium heparin for blood gas analysis (pH, HCO3- (std), base deficit BE(ECF), PaCO2, SaO2, PaO2, sodium, potassium, chlorine, glucose, Hb, Ht, and lactate). The arterial catheter was filled with heparinized saline solution (0.9% NaCl with 5UI/mL of sodium heparin) to prevent it from clotting until the experimental protocol was carried out.…”

“…Te physiological and morphological particularities of felines difer from the canine species mainly because these animals are less tolerant to handling and physical restraint [1][2][3][4].…”