Double lumen tube placement with the Bullard laryngoscope.

Abstract

Placement of double lumen tubes (DLTs) in both normal and difficult airways may be considerably more difficult than standard laryngoscopy and intubation using standard tracheal tubes. Alternative techniques to place DLTs have not been uniformly successful and alternative tracheal tubes do not provide the versatility afforded by the DLT. We intubated the tracheas of patients undergoing thoracic procedures requiring DLTs with the Bullard laryngoscope (BL) to determine its efficacy and outline its shortcomings. Twenty nine consecutive patients scheduled for general anesthesia requiring DLT were evaluated. The laryngeal view, time to intubation and the reason for any difficulty with intubation were recorded. Any patient who required a second DLT placement had the second attempt performed via standard laryngoscopy. The time to laryngoscopy was 9+/-5 sec, and the time to intubation was 28+/-10 sec. All patients had Cormack scores of grade of 1 through the BL. The placement of the bronchial lumen of the DLT was found to be in the correct location (left mainstem bronchus) in 9 of 28 patients. The BL appears to be effective in the placing DLT into the trachea of patients.