Electromyographic Endotracheal Intubation in Pig: A Technique to Insert Electromyographic Tube Inside the Pig Trachea

Begin by prepping an anesthetized pig in the prone position. Pull the pig's jaws to open its mouth and slightly extend the tongue out. Place a laryngoscope over the tongue and push it down to visualize the laryngeal opening.

The larynx, or voice box, is a cartilaginous organ connecting the throat with the trachea, containing the membranous folds or vocal cords for generating sound. The opening of the larynx is guarded by the epiglottis – a leaf-like cartilaginous flap which covers the trachea during swallowing.

Now, move the laryngoscope toward the tongue's base and push the epiglottis down to reveal the tracheal opening. Carefully insert an elastic bougie – a flexible introducer that facilitates tubing insertion into the trachea.

The bougie is preloaded with an electromyography, or EMG, tube with a recording electrode to monitor the real-time electrical activity of laryngeal muscles. Next, advance the EMG tube over the bougie into the trachea at an appropriate depth.

Gently remove the bougie followed by laryngoscope, and immediately inflate the EMG tube cuff. The inflated cuff anchors the EMG tube within the trachea and creates a seal that protects the airway against leakage. Thereafter, connect the EMG tube to a ventilator to provide breathing support to the animal during subsequent surgical procedures.