APPLICATION OF ORO-PHARYNGEAL AIRWAY
INTRODUCTION
In anesthetized or unconscious patients, the soft tissues of the oropharynx, especially the
tongue, can obstruct the passageway between the mouth and the glottis. Oropharyngeal
airways (OPAs) are used to stent open the oropharynx to allow passage of air/oxygen through
the oropharynx. The majority of OPAs are made of curved hard plastic to conform to the
oropharynx. They usually have an interior channel that allows the passage of gas or suction
devices from the mouth opening through the channel into the posterior pharynx
OPAS USES
Anesthetized or unconscious patients who cannot be easily ventilated by bag/mask
ventilation
Who are spontaneously breathing but have airway obstruction.
1. They are usually not tolerated by awake patients and can cause gagging and even
vomiting when used in a conscious or semiconscious patient.
2. When inserting an oral airway, the anaesthesia provider may use a tongue depressor to
keep the oral airway from pushing the tongue back into the pharynx.
SIZE
OPAs come in a variety of sizes from new-borns to extra-large adults and are often
color coded to indicate the size of the airway. It is available in sizes 000–6. (40-120
mm)
Oropharyngeal airway Actually a better insertion method is to insert the airway at a
180-degree angle and then rotate it into position over the tongue
TYPE OF OROPHARYNGEAL AIRWAY:
1. Guedel Airway
A Guedel is a rigid plastic tube which sits along top of mouth and ends at base of
tongue (an adjunct to help keep airway open)
2. Safar’s Airway
It is available in sizes for adult and paediatric. It is an “S” shaped airway that
looks like two airways joined together. It is made of non-traumatic soft rubber. It
is mainly used for artificial resuscitation.
3. BERMAN INTUBATION PHARYNGEAL AIRWAY
❖Sizes are available for infant, small child, child, medium adult, and large adult.
It has no enclosed air channel. The sides are cut open and there is support
through the centre.
❖It is easier to clean and is less likely to become obstructed with foreign body or
Mucus
4. OVASSAPIAN FIBEROPTIC INTUBATING AIRWAY
It is designed for use during fiberoptic intubation.
5. WILLIAMS AIRWAY INTUBATOR:
• The Williams airway intubator was designed for blind orotracheal intubations. The
tracheal tube connector should be removed during intubation, because it will not pass
through the airway.
6. CUFFED OROPHARYNGEAL AIRWAY
• it can be as an alternative to the face mask use during spontaneous ventilation
anaesthesia
• It is a modified Guedel type of oropharyngeal airway.
• The inflatable cuff (capacity of 25–40 mL of air).
NASOPHARYNGEAL AIRWAY:
• Description Nasopharyngeal airways are made of soft plastic, or latex rubber
and have either a fixed or adjustable flange at its proximal end and a bevelled
distal end. It curves to fit the curvature of the nasopharynx. It is available in a
range of lengths and internal diameters.
• Important note1: These airways are inserted through the nose and into the
posterior pharynx. where they can prevent the tongue from collapsing against
the posterior wall of the oropharynx.
• Important note2: It is useful in patients who have limited mouth opening or
pathology of oral cavity that makes it difficult to insert oral airway.
• Important note3: Other uses of nasal airway are during pharyngeal surgery,
fiberoptic bronchoscopy, to apply CPAP and facilitate suctioning.
• Important note4: It is better tolerated in a semi-awake patient than an oral
airway and is less likely to be accidentally displaced or removed
Nasopharyngeal Airway Not recommended in coagulopathy, nasal sepsis and
deformities.
