Efficacy of lung isolation with double-lumen bronchial tube versus bronchial blocker on one-lung ventilation by using short apnea combined with internal channel occlusion technique
Objective To compare the efficacies and safeties of double-lumen bronchial tube(DLBT)and bronchial blocker(BB)for lung isolation in one-lung ventilation(OLV)by using short apnea combined with internal channel occlusion(SAICO)technique.Methods Ninety-five patients were scheduled for video-assisted thoracoscopic surgery for partial lung resection in Beijing Friendship Hospital Affiliated to Capital Medical University from January to December 2022,and were randomly divided into 47 patients receiving lung isolation with DLBT(DLBT group)and 48 patients receiving lung isolation with BB(BB group).The SAICO technique was used for OLV in both groups.The time for complete lung deflation,intubation time,lung isolation time,and mechanical ventilation parameters were observed.The mean artery pressures and heart rates before induction of anaesthesia(T1),at tracheal intubation(T2)and at the end of correct device placement(T3),and the incidences of sore throat and hoarseness 24 h postoperatively were observed in two groups.Results The time for complete lung deflation was shorter in BB group[13(9,16)min]than that in DLBT group[15(13,17)min](Z=-2.289,P=0.022).The intubation time and lung isolation time were longer in BB group[62.0(42.0,77.0),110.0(84.0,132.0)s]than those in DLBT group[32.0(30.5,43.0),74.0(65.5,90.5)s](Z=-6.137,P＜0.001;Z=-4.646,P＜0.001).The peak airway pressure during OLV was lower in BB group[21(19,23)cmH2O]than that in DLBT group[23(21,24)cmH2O](Z=-2.831,P=0.005).There were no significant differences in the quality of lung deflation immediately after pleurotomy,positioning time and malposition rate of studied devices,tidal volume,peak airway pressure and airway platform pressure during double-lung ventilation,time between OLV to pleurotomy,OLV duration,tidal volume during OLV,airway platform pressure,and incidence of hypoxemia before and after pleurotomy between two groups(P＞0.05).The mean artery pressure and heart rate at T2,and the incidences of mild and moderate sore throat and hoarseness 24 h postoperatively were lower in BB group[(103.7±6.4)mmHg,(78.0±10.6)beats/min,62.5％,56.3％]than those in DLBT group[(111.7±6.5)mmHg,(87.9±9.6)beats/min,80.8％,76.6％](t=-6.139,t=4.652,x2=6.869,x2=7.405,all P values＜0.05),and there were no significant differences in the mean artery pressures and heart rates at T1 and T3 between two groups(t=0.467,-0.813,0.371,-1.524;all P values＞0.05).Conclusions Both DLBT and BB can achieve satisfactory lung deflation at surgical side when using"SAICO technique"for OLV.However,BB causes less airway procedures-related hemodynamic changes compared with DLBT,with a reduced peak airway pressure during OLV and low incidences of postoperative sore throat and hoarseness.
NETL
NSTL
万方数据
