The v-gel Advanced Dog is inferior to the endotracheal tube for sealing the airway in healthy canine anesthesia.

Abstract

Objective: To assess the v-gel Advanced Dog supraglottic airway device (SGAD) safety and efficacy compared to a high-volume, low-pressure endotracheal tube (ETT).

Methods: In a prospective randomized study, 30 client-owned mesocephalic canine patients (American Society of Anesthesiologists physical status I or II, scheduled for elective surgery) were to be enrolled and assigned to the SGAD or ETT group (15 SGAD; 15 ETT) by blocked randomization. Endotracheal tube cuffs were inflated to 25 cm H2O with a cuff inflator. The primary outcome was anesthetic circuit pressure decrease (leak) of inspiratory air at escalating anesthetic system pressures, tested at 0, 10, 15, and 20 minutes after airway device placement.

Results: Due to safety concerns, the study was terminated after 6 patients in the SGAD group failed leak pressure testing under 20 cm H2O at all time points. Thirteen canines (6 SGAD, 7 ETT) were enrolled from September through October 2023. The risk of leaking for the SGAD group was significantly higher than that of the ETT group at 12 cm H2O (P = .005) and at 16 cm H2O (P = .001). There were no perioperative or postoperative adverse events or significant differences in characteristics between airway device groups except that the risk for not requiring manipulations to obtain and maintain an effective airway for the SGAD group was 67% less (relative risk, 0.33; exact 90% CI, 0.06 to 0.74) than that of the ETT group.

Conclusions: The SGAD, but not ETT, failed leak pressure testing < 20 cm H2O.

Clinical relevance: The v-gel Advanced Dog SGAD was not safe to deliver inhalant anesthetics due to the device failing leak pressure testing under 20 cm H2O.