The Use of LMA-Proseal and Endobronchial Blocker for One Lung Anesthesia, Case Series

Mahidol University29 enrolled

Overview

An observational pilot study to determine the success rate of using LMA Proseal in conjuction with endobronchial blocker to provide one-lung anesthesia for thoracic surgery.

The use of LMA has gained popularity secondary to benefits confirmed by many literatures. However, LMA is rarely used in thoracic surgery. To enable one-lung ventilation, the LMA need to be used with bronchial blocker. The use of this combination has been reported as a rescue technique in special clinical scenarios, i.e. patient with difficult airway. When used in patient with difficult airway, the LMA will be inserted until proper ventilation achieved, then endobronchial blocker will be subsequently placed through the LMA into the selected main bronchus. The success rate of the the bronchial blocker placement via properly placed LMA has never been studied. This pilot study was designed to evaluate the success rate, the quality of lung collapsed, the dislodgement or other associated problems including some minor complications i.e. postoperative dysphagia, sore throat hoarseness of voice.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Anesthetic Technique One-lung Ventilation

Interventions

Bronchial blocker (Coopdech, Arndt)DEVICE

Using bronchial blocker with LMA

LMA-ProsealTMDEVICE

Eligibility

Sex: ALLMin age: 18 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * thoracic surgery that needed one-lung ventilation Exclusion Criteria:patient with * Restrictive lung disease that needed positive pressure ventilation \> 30 cm.H2O * Mass or hematoma in the mouth which obstruct LMA insertion * Emergency surgery * Pregnancy * Severe infection or active pulmaonary tuberculosis * Hemoptysis * Pulmonary nodule \> 20 cm. or bronchilal pathology * Pneumonectomy or sleeve resection

Locations (1)

Department of Anesthesiology, Faculty of Medicine, Siriraj Hospital

Bangkok, Thailand

Outcomes

Primary Outcomes

success rate

can provide one-lung ventilation within 15 mintues

Time frame: 15 mintues

Secondary Outcomes

Time consuming in achieving one-lung anesthesia

Total time spent to place bronchial blocker into the selected main bronchus shall not exceed 15 minutes. If investigators failed, the study will be terminated and patient will receive appropriate conventional airway management.

Time frame: 15 mintues

Sorethroat

Patient self assessment scale as followed 0 - no sore throat 1. \- mild sore throat (no pain at rest, only with swallowing, does not require intervention) 2. \- moderate sore throat (some discomfort at rest, more with swallowing - but does not need medications) 3. \- severe sore throat (at rest, require analgesics for sore throat)

Time frame: 1 day

Hoarseness of voice

Patient assessment scale by visitor as followed 0 - no hoarseness of voice detected, normal voice. 1. \- some hoarseness of voice detected but able to speak in all octaves. 2. \- notable hoarseness of voice, unable to phonate in high pitch. 3. \- marked hoarseness of voice, unable to phonate

Time frame: 1 day

Difficulty swallowing

Patient self assessment and visitor assessment in scale as followed. 0 - no problem swallowing. no pain. 1. \- some sore throat (grade 1) with swallowing but able to swallowing both liquid and solid. 2. \- moderate swallowing limitation, only liquid or soft diet swallowing - unable to swallow solid food 3. \- marked swallowing limitation, patient prefers to fast due to pain associated with swallowing. Speech therapist/OT/PT consult to evaluation swallowing problems

Time frame: 1 day

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.