Safety comparison of bronchial blocker and double-lumen endotracheal tube on one lung ventilation in the elderly

Abstract

Objective To compare the safety and impact of bronchial blocker and double-lumen tube on one lung ventilation undergoing video-assisted thoracoscopic surgery(VATS)lobectomy in the elderly. Methods One hundred patients underwent pulmonary lobectomy were randomly divided into two groups with 50 cases in each group: groupⅠreceived bronchial blocker and groupⅡreceived double-lumen endotracheal tube. The tracheal intubation was performed by the same deputy chief physician of anesthesia. Hemodynamic changes during intubation and the time of intubation, tube localization, peak airwany pressure, operation visual field exposure and the arterial blood gas analysis of 40 minutes after the opening of the pleural were recorded. Sore throat hoarseness, cough and vocal cord lesions 24 hours after the operation were examined by bronchoscopy immediately in the two groups. Results Compared with group Ⅱ, the time of intubation in groupⅠwas shorter(P<0.05). Postoperative occurred of sore throat, hoarseness, cough and vocal cord lesions more frequentely in the groupⅡ than those in the group Ⅰ(P<0.05). There was no significant difference in tube localization time or surgical satisfaction between the two groups. Conclusions One-lung ventilation can be achieved via either a bronchial blocker or a double-lumen bronchial tube for the patients undergoing VATS lobectomy. However, occluder is recommended for single-lung ventilation in elderly patients because it can reduce the incidence of vocal cord injuries, postoperative hoarseness, sore throat and coff. Key words: One lung ventilation; Dronchial blocker; Double-lumen tube