Jiang Yan1, Zhang Rufang2, Wei Rong3, Zhang Wangping4. 1. Department of Anesthesiology, Shanghai Children's Hospital, Shanghai JiaoTong University, Shanghai, China. 2. Department of Cardiothoracic Surgery, Shanghai Children's Hospital, Shanghai JiaoTong University, Shanghai, China. 3. Department of Anesthesiology, Shanghai Children's Hospital, Shanghai JiaoTong University, Shanghai, China. Electronic address: weirongej@163.com. 4. Department of Anesthesiology, Women and Children's Hospital of Jiaxing University, Jiaxing, China.
Abstract
OBJECTIVE: The purpose of the present study was to evaluate the efficacy of extraluminal use of the bronchial blocker (BB) for one-lung ventilation (OLV) in infants undergoing thoracoscopic surgery. DESIGN: This was a prospective, randomized, controlled clinical study. SETTING:University hospital. PARTICIPANTS: The study comprised 60 infants undergoing thoracoscopic surgery. INTERVENTION: The study included 2 groups. A BB was placed extraluminally for OLV in group A, and a single-lumen endobronchial tube was inserted into the desired mainstem bronchus for OLV in group C. MEASUREMENTS AND MAIN RESULTS: The placement time (4.0 ± 0.6 min v 6.3 ± 4.1 min; p = 0.04) and the number of repositions (2 v 11; p = 0.005) were less in group A. There were significant differences in the heart rate and blood pressure after insertion between the 2 groups (p < 0.05). The tidal volumes and end-tidal pressure of carbon dioxide values 10 minutes after the initiation of OLV were similar between the 2 groups (p > 0.05). The incidence of intraoperative hypoxemia was reduced in group A compared with group C (0% v 20%; p = 0.024). No postoperative adverse events were observed in either group. CONCLUSIONS: Extraluminal use of the BB may provide a solution for a rapid placement and excellent quality of lung isolation, and it may reduce the incidence of intraoperative hypoxemia in infants without increasing the incidence of hoarseness.
RCT Entities:
OBJECTIVE: The purpose of the present study was to evaluate the efficacy of extraluminal use of the bronchial blocker (BB) for one-lung ventilation (OLV) in infants undergoing thoracoscopic surgery. DESIGN: This was a prospective, randomized, controlled clinical study. SETTING: University hospital. PARTICIPANTS: The study comprised 60 infants undergoing thoracoscopic surgery. INTERVENTION: The study included 2 groups. A BB was placed extraluminally for OLV in group A, and a single-lumen endobronchial tube was inserted into the desired mainstem bronchus for OLV in group C. MEASUREMENTS AND MAIN RESULTS: The placement time (4.0 ± 0.6 min v 6.3 ± 4.1 min; p = 0.04) and the number of repositions (2 v 11; p = 0.005) were less in group A. There were significant differences in the heart rate and blood pressure after insertion between the 2 groups (p < 0.05). The tidal volumes and end-tidal pressure of carbon dioxide values 10 minutes after the initiation of OLV were similar between the 2 groups (p > 0.05). The incidence of intraoperative hypoxemia was reduced in group A compared with group C (0% v 20%; p = 0.024). No postoperative adverse events were observed in either group. CONCLUSIONS: Extraluminal use of the BB may provide a solution for a rapid placement and excellent quality of lung isolation, and it may reduce the incidence of intraoperative hypoxemia in infants without increasing the incidence of hoarseness.