Comparison of Success and Complications of Lung Separation with Bronchial Blocker and Double Lumen Tube in Thoracoscopic Surgery

Abstract

There are few data comparing the use of bronchoblockers with double-lumen endotracheal tubes in single-lung ventilation surgery. The more rigid nature of the double lumen in double-lumen tubes compared to bronchial blockers can cause problems during surgical procedures; Therefore, it will be useful to compare different airway management methods for this type of surgery. The researchers of this study hypothesize that the bronchial blocker clinically performs better than double-lumen endotracheal tubes for lung isolation and causes less harm to patients undergoing video-assisted thoracoscopic surgery. The purpose of this study is to compare intubation by bronchial blocker and double lumen in thoracoscopy. Materials and Methods: This study is a randomized clinical trial that was conducted during 2021 with the participation of 44 thoracoscopic surgery candidates at Tabriz University of Medical Sciences. Patients were randomly divided into two groups. For patients in the single lumen group, a double lumen (size selection based on the relevant formula) was installed. For patients in the bronchial blocker group, a simple endotracheal tube was inserted for all patients. The bronchial blocker was placed distally in the main bronchus and its cuff remained full. Finally, the duration of intubation, the complications of intubation and the rate of lung collapse were compared between the two groups of participants. Results: Heart rate, systolic and diastolic blood pressure in the first minute after laryngoscopy and during lung collapse were significantly higher in double lumen group patients than in bronchial blocker group patients. The interpretation of arterial blood gases during lung collapse indicated that none of the variables in ABG interpretation had statistically significant changes in patients with right and left lung surgery in the double lumen and bronchial blocker groups. The duration of double lumen implantation was 21.45±3.26 seconds, while this duration in the bronchial blocker group was 29.96±2.11 seconds, which was significantly higher (P=0.036). Comparison of the state of lung collapse indicated that the collapse in the double lumen group was significantly better than the bronchial blocker group (P=0.041). Laryngeal spasm after extubation was significantly higher in the double lumen group than in the bronchial blocker group (P=0.039); Throat pain was almost the same in both groups (P=0.985) and the harshness of the voice was insignificantly higher in the patients of the double lumen group than in the bronchial blocker group (P=0.071).