Positioning of double-lumen endobronchial tube with fiberoptic bronchoscope / 中华麻醉学杂志

ABSTRACT

Objective To study the use of fiberoptic bronchoscope in the positioning of double-lumen endobronchial tube in Chinese patients. Methods Ninety ASA Ⅰ - Ⅱ patients (60 male and 30 female) undergoing thoracic surgery requiring one-lung ventilation were enrolled in the study. Age ranged from 14-79 years (mean age 56 ?16) and the average height was 169? 6 cm (male) and 158?6 cm (female) respectively. Anesthesia was induced with fentanyl, propofol and vecuronium. Double-lumen endobronchial tube (Broncho-Cath, Mallincrodt Medical) was inserted following conventional procedure. Proper position of double-lumen tube(DLT) was determined by auscultation. Fiberoptic bronchoscope was made if needed. The fiberoptic bronchoscopy was repeated after lateral decubitus positioning of the patient. The depth of the tube inserted was recorded. Results The fiberoptic bronchoscopy revealed that the incidence of malpositioning of the left-sided DLT was 68% and of right-sided DLT was 62% . The most common malposition was that the tube was placed too deep. The dislodgement of DLT in lateral decubitus positioning of the patient occurred in 24% patients and in most cases the DLT was moved upward. The depth of insertion did not correlate with the patient' s height. Conclusion Fiberoptic bronchoscopy is a reliable technique for correct positioning of DLT and should be used routinely.