Clinical Application Of Placing Endobronchial Blocker Through Lateral Orifice Of Endotracheal Tube For One Lung Ventilation In Adults

Objective:This study aims to explore the feasibility and effectiveness of placing bronchial blocker through the lateral orifice of endotracheal tube to reduce the malposition of the bronchial blocker,and to provide references and practical prescription applications for the clinician.Methods:Patients undergoing elective thoracoscopic lobectomy were enrolled and divided into two groups by random number table method.The endobronchial blocker was inserted through the lateral orifice of endotracheal tube in the experimental group,whereas the endobronchial blocker was inserted through the front opening of the endotracheal tube in the control group.Patients in both groups were received the same anesthesia induction plan.The primary outcome was the incidence of endobronchial blocker malposition.The secondary outcomes included the duration of intubation,time to achieve endobronchial blocker placement,the first attempt success rate of endobronchial blocker placement,the number of cases with endobronchial blocker damage,the quality of lung collapse,and the incidence of hoarseness and sore throat after surgery.Results:A total of 52 patients were available for analysis,and none were excluded.Twenty-six patients each were included in the experimental group and the control group.1.Demographic:The median age was 50.85 y(SD,7.15).The mean height was 1.65 m(SD,0.07).The mean weight was 66.58 kg(SD,9.11),The mean BMI was 24.46 kg/m~2(SD,1.61).The sex ratio was 31/21(male/female).Twenty-two patients(42%)underwent left lung surgery whereas thirty patients(58%)underwent right lung surgery.Thirty-four patients(65%)had an ASA classification ofⅡ,and eighteen patients(35%)had an ASA classification of III.2.Primary outcome:The malposition rate of endobronchial blocker in experimental group was significantly lower than that in control group(8%vs 35%,P<0.05).3.Secondary outcomes:The duration of intubation in experimental group was significantly shorter than that in control group(39.19±4.80 vs 65.31±4.16,P<0.05).The time to achieve endobronchial blocker placement in experimental group was also less than that in the control group(57.08±3.88 vs 75.46±6.11,P<0.05).The experimental group possessed a higher first attempt success rate of endobronchial blocker placement as compared to the control group(100%vs 77%,P<0.05).The quality of lung collapse was significantly improved in the experimental group(100%v s73%,P<0.05).The incidence of postoperative hoarseness and sore throat patients was lower in the experimental groups(P<0.05).The number of cases with endobronchial blocker damage did not differ between the groups(P>0.05).Conclusion:Placing endobronchial blocker through lateral orifice of endotracheal tube was feasible and effective for one lung ventilation in adults,and reduced the malposition of the endobronchial blocker.