A comparison of double-lumen endotracheal tube with univent blocker and bronchial blocker during thoracic surgical anesthesia

Abstract

To compare the effectiveness of lung isolation among double-lumen endotracheal tube, Univent blocker and bronchial blocker during thoracic surgical anesthesia. A total of 120 patients undergoing elective thoracic surgery were enrolled. They were intubated with Mallinckrodt DLT (DLT group, n = 40), Univent blocker (UNI group, n = 40) and Coopdech bronchial blocker (BB group, n = 40) after intravenous anesthesia induction. The following parameters were recorded:(1) time to initially position the assigned tube; (2) changes of mean arterial pressure (MAP) and heart rate (HR) at 5 min post-intubation; (3) lung collapse scores; (4) frequency of malpositions; (5) airway press and blood gas change during one lung ventilation (OLV); (6)postoperative sore throat at 24 h postoperation. No statistical difference existed in positioning three types of endotracheal tubes. But MAP and HR were higher at post-intubation in DLT group compared with the other 2 groups. No difference existed among the lung isolation devices in lung collapse scores at 5/10 min after pleural opening. As compared with the UNI and BB groups, Ppeak and Pplat increased while compliance decreased in DLT group during OLV. Statistical differences existed in tube malpositions among three groups (n = 4, DLT; n = 5, UNI; n = 8, BB). The incidence of postoperative sore throat was significantly higher in DLT group (70%) than the other two groups (37.5%, UNI; 22.5%, BB). As compared with DLT, Univent and Coopdech bronchial blocker may reduce the airway injury and improve the compliance during OLV. But there is a higher intraoperative incidence of tube malposition.