Many intrathoracic procedures demand optimal collapse of the operative lung to facilitate surgical exposure. Single-lung ventilation can be achieved using a double-lumen tube (DLT), a Univent tube, or an independent bronchial blocker. Insertion of a DLT using a direct laryngoscope can be more difficult than that of single-lumen tube (SLT), especially in patients for whom airway difficulty is anticipated. The safest of the proposed methods involves the placement of an SLT with the aid of an fibreoptic bronchoscope (FOB), following which the SLT is replaced with a DLT using an airway exchange technique in these patients. HumanBroncho® (Insung Medical, Seoul, Korea) is a new silicone DLT with a soft, flexible, non-bevelled, wire-reinforced tip. The oval shape, obtuse angle, and short lateral internal diameter of the bronchial lumen and its flexibility may allow for advancement to the trachea over the FOB with as much as ease as a standard SLT. In the present study, the investigators aimed to test the hypothesis that the HumanBroncho® DLT would be non-inferior to a standard SLT with regard to intubation time over an FOB in patients with semi-rigid neck collar simulating difficult airway.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
DOUBLE
Enrollment
80
neck collar apply. fibreoptic intubation with single lumen tube and bronchial blocker.
neck collar apply. fibreoptic intubation with double lumen tube.
Ajou universiry hospital
Suwon, Gyeonggi-do, South Korea
intubation time
the time from the passage of the fibreoptic bronchoscope beyond the teeth, to tracheal tube positioning above the carina.
Time frame: through study completion, an average of 4 hour
insertion time
the time from the passage of the fibreoptic bronchoscope beyond the teeth, to fibreoptic bronchoscope positioning above the carina
Time frame: through study completion, an average of 4 hour
railroading time
the time from fibreoptic bronchoscope positioning above the carina to tracheal tube positioning above the carina.
Time frame: through study completion, an average of 4 hour
grade of ease of insertion over fibreoptic bronchoscope
1, no difficulty passing the tube; 2, obstruction while passing the tube, relieved by withdrawal and a 90° counter-clockwise rotation; 3, obstruction necessitating more than one manipulation or external laryngeal manipulation; 4, direct laryngoscopy was required.
Time frame: through study completion, an average of 4 hour
trauma around the glottis
fibreoptic observation of the glottic bleeding.
Time frame: through study completion, an average of 4 hour
complication at the post-anesthesia care unit
hoarseness, sore throat, swallowing difficulty
Time frame: through study completion, an average of 4 hour
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