Anaesthetic equipment for thoracic surgery

Abstract

Thoracic surgery and anaesthesia increasingly require the use of selective one lung ventilation. This article reviews the use of double-lumen endobronchial tubes and bronchial blockers in this context. In the UK, the two most commonly used double-lumen endobronchial tubes are the Robertshaw (Phoenix Medical) and the Bronchocath (Mallinckrodt) tubes; these are described in some detail. Renewed interest is being shown in the use of bronchial blockade to achieve one lung ventilation, particularly with the increase in use of videoscopic surgical techniques. The use of bronchial blockers is briefly described along with potential advantages of their use, for example, in difficult intubation and when selective lobar blockade is required. Despite the increasing sophistication of endobronchial blockers and tubes there is considerable evidence that accurate placement can only be achieved with the use of fibreoptic bronchoscopy. This is also discussed.