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The use of bougie-guided insertion of a laryngeal mask airway device in neonatal piglets after unexpected complications
  1. Ute Morath1,
  2. Hege Kippenes Skogmo2,
  3. Birgit Ranheim3 and
  4. Olivier Louis Levionnois1
  1. 1Department of Veterinary Anaesthesiology and Pain Therapy, Vetsuisse Faculty, University of Bern, Laenggassstrasse 124, Bern 3012, Switzerland
  2. 2Department of Companion Animal Clinical Sciences, Norwegian School of Veterinary Science, Oslo, Norway
  3. 3Department of Food Safety & Infection Biology Section of Veterinary Pharmacology and Toxicology, Norwegian Veterinary School, PO Box 8146 Dep, Oslo 0033, Norway
  1. Correspondence to Dr Ute Morath, ute.morath{at}


After marked airway obstruction with laryngeal mask (LM) placement in neonate piglets, anatomical observations in cadavers revealed a large epiglottis advancing markedly over the soft palate. CT imaging in vivo confirmed that the LM pushes the epiglottis caudally thereby obstructing the larynx. As a new approach, in 20 piglets a flexible PVC bougie placed under laryngoscopy was used to guide the LM to the correct position at the larynx. Placement of the bougie was easy and the LM was positioned successfully in all piglets at first attempt. In 14 piglets, the epiglottis was positioned dorsal to the soft palate before LM insertion and had to be pushed downwards to advance the bougie. In case of failure of LM placement with potential airway obstruction, the use of a bougie to guide the LM over the epiglottis was simple, rapid, and improved the success rate without complication.

  • Anaesthesia
  • Pigs
  • Laboratory animals
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