Comparison of a Double Lumen Endobronchial Tube with a Single Lumen Tube with Bronchial Blocker for One Lung Anesthesia / 대한마취과학회지

BACKGROUND: Double lumen endobronchial tube and single lumen tube with bronchial blocker are most frequently used tubes for one lung anesthesia. This study compared the double lumen endobronchial tube with the single lumen tube with bronchial blocker to determine whether there were objective advantages of one over the other during one lung anesthesia. METHODS: Sixty patients were randomly assigned to one of two groups. Thirty patients were intubated with a left-sided double lumen endobronchial tube, and thirty patients were intubated with a single lumen tube with bronchial blocker. Each group was subdivided into two groups with a person intubating (i,e, certified anesthesiologist or resident) to compare the easiness of intubation according to the type of tube. Fiberoptic flexible bronchoscope was used in all patients. The following were studied 1) time required to position each tube until satisfactory placement achieved, 2) frequency of malposition after initial placement with fiberoptic bronchoscopy, 3) surgical exposure ranked by surgeons blinded to type of tube used, 4) easiness of tracheobronchial toilet (TBT). RESULTS: 1) Statistically significant differences were observed in time required to place each tube by resident(double lumen tube 5.73+/- 0.48 min. versus single lumen tube with bronchial blocker 4.18+/-0.70 min (P<0.05) and in easiness of TBT (double lumen tube 18/30 versus single lumen tube with bronchial blocker 27/30) (P<0.05). 2) No differences were observed in time required to position each tube by anesthesiologist, the frequency of malposition and surgical exposure. CONCLUSIONS: Single lumen tube with bronchial blocker is better in easiness of intubation by resident and in easiness of TBT than double lumen endobronchial tube. But the selection of two tubes depends upon type of surgery and familiarity of each tube by the anesthesiologist.

Prediction of Depth of Left-sided Double Lumen Tube Insertion Using Preoperative Chest X-ray / 대한마취과학회지

INTRODUCTION: Accurate placement of double-lumen endobronchial tube (DLT) is essential for optimal gas exchange and collapse of nondependent lung during one-lung anesthesia. The goal of this study was to determine if measurement of tracheal length from the preoperative chest X-ray can be used for the prediction of adequate length of left-sided DLT insertion. METHODS: 25 patients scheduled for elective thoracotomy under one-lung anesthesia were studied. After measurement of tracheal length from preoperative chest X-ray and of length from incisor to vocal cord during intubation, the patient was intubated with left-sided DLT to the depth of predetermined length from incisor to carina. The tube position was evaluated with fiberoptic bronchocsope. RESULTS: In 22 patients (88%) the DLTs were positioned satisfactorily, and in three patients it was required to reposition DLT. CONCLUSIONS: This technique may be useful for accurate placement of DLT for the one-lung anesthesia.

The Incidence of Sore Throat and Hoarseness after Double-Lumen Endobronchial Tube Intubation / 대한마취과학회지

INTRODUCTION: Sore throat and hoarseness often follow general anesthesia administered via a single-lumen endotracheal tube (SLT). Numerous studies have investigated the role of factors as contributing causes, but the influence of double-lumen endobronchial tube (DLT) has not been examined systemically. The goal of this study was to examine the incidence of sore throat and hoarseness after DLT insertion. METHODS: 70 patients who were intubated with SLT or DLT were studied. Sore throat and hoarseness were evaluated after 24~48 hr from extubation of each tubes. RESULTS: In SLT and DLT group, the incidence of sore throat and hoarseness was 14 patients (40%) vs 16 patients (45.7%) and 8 patients (22.8%) vs 10 patients (28.5%), respectively. CONCLUSIONS: There are no statistical differences in incidence of sore throat and hoarseness between SLT and DLT.

Anesthetic Management of Lung Lavage in Patient with Pulmonary Alveolar Proteinosis Related to Pneumoconiosis: A case report / 대한마취과학회지

Lung lavage is an accepted modality for treatment of pulmonary alveolar proteinosis. The procedure can be accomplished by the use of double lumen endobronchial tube, with lavaging of one lung while the other is ventilated. As lung lavage is an intentional drowning, particular attention must be paid to potentially serious complications such as severe hypoxemia. We report a case of lung lavage in a patient with secondary pulmonary alveolar proteinosis performed safely by careful monitoring of oxygenation and hemodynamics.