Analyze The Effect Of One-Lung Ventilation Of Left And Right Double-Lumen Bronchial Tubes In The Resection Of Lung Bullae Under Thoracoscope

Objective:To analyze the effect of one-lung ventilation of left and right double-lumen bronchial tubes in the resection of lung bullae under thoracoscope.Methods:90 cases with lung bullae were treated under thoracoscope randomly divided into L group (applying left double-lumen tube, n=45) and R group (applying right double-lumen tube, n=45). The Midazolam, Dezocine, Cis-atracurium and Etomidate were used to induce general anesthesia.The L group patients were inserted with left double-lumen tubes while the R group were inserted with right double-lumen tubes. Meanwhile, the rate of the first-time successful intubation, the intubation time, the displace rate at the end of tubes, the incidence rate of hypoxemia, and the usage number of fiberoptic bronchoscope (FOB) were analyzed in the two groups. The changes of the oxygen saturation (SpO2), the mean arterial pressure (MAP), heart rate (HR) and peak inspiratory pressure (Ppeak) were also analyzed. The changes of arterial partial pressure of oxygen (PaO2), the partial pressure of carbon dioxide in artery (PaCO2) and the arterial oxygen saturation (SaO2) at 1min before one-lung ventilation (TO), 10min after one-lung ventilation (T1),20min after one-lung ventilation (T2), 30min after one-lung ventilation (T3),45min after one-lung ventilation (T4) and 60min after one-lung ventilation (T5) as well as 15min after recovering two-lung ventilation (T6)were analyzed in the two groups.Results:(1)The MAP, HR, PaO2, SaO2, PaCO2 and SpO2 were no statistical differences at various time points of two-lung ventilation, one-lung ventilation and recovering two-lung ventilation between the two groups(p>0.05).(2) Compared within each group,the PaO2 obviously decreased at various time points (T1,T2,T3,T4 and T5) in one-lung ventilation than the time of two-lung ventilation (TO), while the Ppeak significantly increased.there were statistical differences in the two groups(p<0.05).(3) The Ppeak was significantly lower at T1, T2 and T3 in one-lung ventilation in L group than that the R group,there were statistical differences (p<0.05).(4) The rate of the first-time successful intubation was significantly higher in the L group than that the R group.Moreover, the intubation time, the displace rate at the end of tubes, the incidence rate of hypoxemia, and the usage number of FOB were lower in the L group than those the R group,there were statistical differences (p<0.05).Conclusion:The PaO2, PaCO2 and hemodynamics changes were no obviously differences using by left and right double-lumen bronchial tubes in the resection of lung bullae under thoracoscope,but the left double-lumen bronchial tubes was more conductive to the anesthesia management.