Orotracheal and nasotracheal intubation in llamas

Orotracheal or nasotracheal intubation was performed in 304 llamas and 6 alpacas during general anesthesia for surgical and diagnostic procedures. The mouth not opening wide and the presence of a prominent torus linguae make orotracheal intubation difficult, but it can be accomplished with the aid of a laryngoscope, using a technique similar to that used in small domestic ruminants. The presence of a pharyngeal diverticulum necessitates modification of nasotracheal intubation techniques to make them applicable for use in llamas and alpacas. When nasotracheal intubation, with phenylephrine lubricant-coated tubes, is not successful, oral laryngoscopy and use of a stylet in the endotracheal tube will improve chances for success. Because llamas are obligate nasal breathers, airway obstruction can develop following removal of endotracheal tubes during recovery from anesthesia. This complication can be prevented by maintaining orotracheal tubes until the animal is able to protect its airway or by using nasotracheal tubes, which allow the llama to stand before the tube has to be removed.