The Elective Combined Use of a Double Lumen Tube and Endobronchial Blocker to Provide Selective Lobar Isolation for Lung Resection following Contralateral Lobectomy

Background Vocal cord injuries, postoperative hoarseness, and sore throat are common complications after general anesthesia. One-lung ventilation can be achieved via two techniques: double-lumen endotracheal tube or endobronchial blocker such as the Arndt blocker. The current study was designed to assess the impact of these techniques for one-lung ventilation on the incidence and severity of postoperative hoarseness, vocal cord lesions, and sore throat. Methods In this prospective trial, 60 patients were randomly assigned to two groups. One-lung ventilation was achieved with either an endobronchial blocker (blocker group) or a double-lumen-tube (double-lumen group). Postoperative hoarseness and sore throat were assessed at 24, 48, and 72 h after surgery. Bronchial injuries and vocal cord lesions were examined by bronchoscopy immediately after surgery. Results In 56 included patients, postoperative hoarseness occurred significantly more frequently in the double-lumen group compared with the blocker group: 44% versus 17%, respectively (P = 0.046). Similar findings were observed for vocal cord lesions: 44% versus 17%, respectively (P = 0.046). The incidence of bronchial injuries was comparable between groups (P = 0.540). Cumulative number of days with hoarseness and sore throat were significantly increased in the double-lumen group compared with the blocker group (P < 0.01). No major complications such as bronchial ruptures were observed. Conclusions Clinicians should be aware of an increased incidence of minor airway injuries that may impair patient satisfaction when using a double-lumen tube instead of an endobronchial blocker for one-lung ventilation.

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The Cohen Flexitip Endobronchial Blocker: An Alternative to a Double Lumen Tube

Anesthesia & Analgesia ◽

10.1213/01.ane.0000184116.86888.d9 ◽

2005 ◽

pp. 1877-1879 ◽

Cited By ~ 46

Author(s):

Edmond Cohen

Keyword(s):

Double Lumen Tube ◽

Double Lumen ◽

Lumen Tube ◽

Endobronchial Blocker

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Clinical Pearls in Anaesthesia for Pleurectomy/Decortication for Malignant Mesothelioma

The Open Anesthesiology Journal ◽

10.2174/1874321801711010029 ◽

2017 ◽

Vol 11 (1) ◽

pp. 29-34

Author(s):

Shagun Bhatia Shah ◽

Itee Chowdhury ◽

Laleng Mawia Darlong ◽

Priyanka Goyal ◽

Anamica Kansal

Keyword(s):

Malignant Mesothelioma ◽

Lung Resection ◽

Lung Ventilation ◽

Double Lumen Tube ◽

Visceral Pleura ◽

One Lung Ventilation ◽

Double Lumen ◽

Lumen Tube ◽

Lung Isolation ◽

Lung Motion

Background: For most thoracic surgeries (lung resection, esophagectomy) the main purpose of inserting a double lumen tube for lung isolation is providing space for dissection and preventing lung motion by not ventilating (collapsing) the lung undergoing surgery. Objective: In addition, during pleurectomy/ decortication surgeries, the anaesthetist can indirectly perform the dissection of pleura from the lung without scrubbing, gloving or holding the scalpel. Conclusion: This is accomplished by ventilating the lung undergoing surgery, with large tidal volumes while the surgeon provides static traction to the visceral pleura. These phases alternate with one lung ventilation. A detailed account of anaesthesia for pleurectomy/ decortication follows.

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Sore Throat or Hoarse Voice with Bronchial Blockers or Double-Lumen Tubes for Lung Isolation: A Randomised, Prospective Trial

Anaesthesia and Intensive Care ◽

10.1177/0310057x0803600601 ◽

2008 ◽

Vol 36 (6) ◽

pp. 441-446

Author(s):

T. Zhong ◽

W. Wang ◽

J. Chen ◽

L. Ran ◽

D. A. Story

Keyword(s):

Sore Throat ◽

Prospective Trial ◽

Lung Ventilation ◽

Double Lumen Tube ◽

One Lung Ventilation ◽

Double Lumen ◽

Lumen Tube ◽

Lung Isolation ◽

Endobronchial Blocker ◽

Hoarse Voice

Double-lumen endotracheal tubes and bronchial blockers allow lung isolation for one-lung ventilation. Few studies, however, directly compare these devices. Further, a new endobronchial blocker (Coopdech) is available in some countries. Our primary hypothesis was that bronchial blockers would be associated with less sore throat or hoarse voice than double-lumen tubes. Secondary outcomes were successful one-lung ventilation and surgical access. In this prospective trial, 120 Chinese patients undergoing elective surgery were randomly assigned to one of four groups of 30 patients: Coopdech blocker, Arndt blocker, Univent tube or double-lumen tube. Postoperative sore throat and hoarse voice were assessed in the recovery room and 24 hours after surgery. The incidence and severity of sore throat or hoarse voice was less in the blocker groups than double-lumen tube group: Coopdech 13%, Arndt 20%, Univent 30% and double-lumen tube 60%, P <0.001. The blocker groups did not significantly differ, P=0.28. Compared to the double-lumen tubes the bronchial blockers took about two minutes less to position but five minutes longer for lung deflation. Surgical exposure was uniformly good across the four groups. We conclude that clinical use of the Coopdech endobronchial blocker is similar to the Arndt and Univent blockers and that all three are associated with less sore throat or hoarse voice than double-lumen tubes.

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