Clinical application of Disposcope endoscope in Univent tube intubation and positioning / 临床麻醉学杂志

Objective To observe the clinical application effects of Disposcope endoscope in Univent tube intubation and positioning.Methods Eighty patients underwent scheduled thoracic sur gery (51 males,29 females,aged 18-77 years,ASA Ⅰ-Ⅲ) under one-lung ventilation (OLV) were randomly grouped into two groups:Disposcope endoscope group (group D) and laryngoscope group (group L),40 patients in each group.Group D used Disposcope endoscope for intubation and positio ning while group L used laryngoscope for intubation and auscultation positioning.Patients with difficult intubation,severe ventilation dysfunction and large sputum volume,such as pulmonary hemoptysis and bronchiectasis,were excluded.Intubation and positioning time,airway pressure and arterial carbon dioxide partial pressure (PaCO2) were recorded during double-lung ventilation and OLV,lung collapse effect,and one-time successful intubation ratio,positionging adjustment ratio and the incidence of intubation complications were calculated.Results Intubation and positioning time were significantly longer in group L than in group D [(169.98±52.65)s vs.(102.38±44.45)s](P＜0.05),one-time successful intubation ratio in group L was lower than that in group D (80％ vs.97.5％) (P ＜0.05).The difference of airway pressure and PaCO2 during double-lung ventilation and OLV between the two groups were not statistically significant.The blocker positioning adjust ratio of Univent tube in group L was significantly higher than that in group D (22.5％ vs.7.5％)(P＜0.05).The incidence of bleeding and sore throat after operation in group L were significantly higher than those in group D (27.5％ vs.7.5％,37.5％ vs.15％) (P＜0.05).Conclusion Compare with laryngoscope for intubation and auscultation positioning,Disposcope endoscope used for Univent tube intubation and positioning needs shorter time for intubation and positioning,higher successful one-time intubation ratio,less positioning adjustment.It also reduces the incidence of intubation complications.

Airway obstruction by dislodgement of an endobronchial tumor fragment during right lung lobectomy using a bronchial blocker: A case report

Dislodgement of tumor fragment with airway obstruction in a dependent bronchus can be a cause of severe hypoxemia, which is a rare but very serious complication of lung surgery. We describe a case of airway obstruction following deflation of a balloon of a bronchial blocker of a Univent tube during right bilobectomy. Following reintubation with a single lumen tube, the patient was simultaneously extubated with the biopsy forceps holding the mass. This report underlines that anesthesiologist should be alert to a possibility of airway obstruction following deflation a balloon of a bronchial blocker.

High Frequency Jet Ventilation of One Lung using a Bronchial Blocker of Univent during Carinal Resection

Airway management during carinal resection should provide adequate ventilation and oxygenation as well as a good surgical field, but without complications such as barotraumas or aspiration. One method of airway management is high frequency jet ventilation (HFJV) of one lung or both lungs. We describe a patient undergoing carinal resection, who was managed with HFJV of one lung, using a de-ballooned bronchial blocker of a Univent tube without cardiopulmonary compromise. HFJV of one lung using a bronchial blocker of a Univent tube is a simple and safe method which does not need additional catheters to perform HFJV and enables the position of the stiffer bronchial blocker more stable in airway when employed during carinal resection.

Use of Univent Tube(R) for Tracheal Gas Insufflation during Laparoscopic Surgery / 대한마취과학회지

BACKGROUND: Laparoscopic surgery is replacing conventional surgical techniques due to its many advantages. However the possibility of respiratory complications during CO2-induced pneumoperitoneum remain. Tracheal gas insufflation (TGI) has been shown to be a useful adjunct to mechanical ventilation in hypercapneic patients. This study investigated the effectiveness of TGI in reducing the PaCO2 level in hypercapneic patients during laparoscopic surgery without increasing the peak inspiratory pressure (PIP) and usefulness of a Univent tube(R) as a device for TGI. METHODS:Twenty-four patients who were scheduled to undergo gynecological laparoscopic surgery, were enrolled in this study. Anesthesia was induced and maintained with propofol, rocuronium and N2O-O2-sevoflurane. The suction port of the endobronchial blocker of the Univent tube(R) was used for the path of TGI. Data including the ABGA and respiratory parameters were measured three times, the pre-CO2 peritoneum (pre-CO2 pneumoperitoneum point, PCP), 15 min after CO2 peritoneum (after-CO2 pneumoperitoneum point, ACP) and after 15 min TGI (TGI point, TGIP). RESULTS: At ACP, the PaCO2 and PIP had increased more significantly than PCP. After TGI, the PaCO2 was decreased more significantly than ACP, but the PIP did not increased. CONCLUSIONS: TGI is a useful adjunct to mechanical ventilation in hypercapneic patients during laparoscopic surgery, and a univent tube(R) is an economic and convenient device for TGI.

Clinical Evaluation of Univent tube in Airway Management during Video-Assisted Thoracoscopic Surgery / 中国微创外科杂志

Objective To evaluate the value of Univent tube in the airway management during one-lung ventilation. Methods A total of 40 patients with pneumothorax undergoing video-assisted thoracoscopic surgery (VATS) were randomly divided into Univent (U) and double-lumen tube (Robertshaw) (D) groups (20 in each). In U group, intubation was performed under the guidance of a fibreoptic bronchoscope; while in D group, the position of the tube was confirmed using fibreoptic bronchoscopy after intubation. The time of intubation, number of secondary dislodgements, quality of lung deflation, peak airway pressure during one-lung ventilation, and blood artery gas analysis data in the two groups were recorded 30 minutes after one-lung ventilation. Results The intubation time in U group was significantly longer than that in D group [(6.18?1.26) min vs (3.26?0.82) min, t=8.654, P=0.000]. The number of secondary dislodgements was 7 in U group, and 5 in D group(U=187.500, P=0.663). No significant difference was detected in the quality of lung deflation between the two groups, (U group: 15 excellent, 3 fair, and 2 poor; D group: 17 excellent, 2 fair, and 1 poor;U=179.500, P=0.583). The peak airway pressure during one-lung ventilation in U group was significantly lower than that in D group [(15.3?3.5) cm H2O vs (21.4?6.6) cm H2O, t=-3.649, P=0.001]; and the oxygen pressure in group U was significantly higher than that in group D [(303.8?65.7) mm Hg vs (258.4?72.9) mm Hg, t=2.066, P=0.046]. No significant difference was found in carbon dioxide pressure and oxygen saturation between the two groups. Conclusion During VATS, univent tube showed the same effectiveness and safety as DLT for one-lung ventilation.