This study investigated the incidence of bronchial blocker malposition in the lateral versus supine position and evaluated the effectiveness of lateral placement.
Routine thoracic surgery anesthesia requires that endotracheal intubation be performed with the patient in the supine position; the patient subsequently needs to be placed in a lateral position through the cooperation of the anesthetist, theatre nurse, and surgeon. Achieving this change in position is time-consuming and likely to result in adverse events, such as loss of the anesthetic airway and arteriovenous catheter, hemodynamic fluctuations, and malposition of the BB which adversely affect anesthesia management and postoperative recovery. For patients with hypertensive heart disease, the risk of cardiovascular and cerebrovascular accidents increases during the perioperative period . Therefore, we conducted a prospective, randomized, controlled, multi-center study to evaluate the ease, efficacy, and safety of video laryngoscopy-guided intubation and bronchial blocker placement performed in lateral position.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
306
In the lateral position group, patients were positioned laterally (as required for surgery) before anesthesia induction. After anesthesia induction, both endotracheal intubation and bronchial blocker placement were performed while the patient remained in the lateral position.
Jie Zhao
Hangzhou, Zhejiang, China
The incidence of bronchial blocker malposition.
The incidence of bronchial blocker malposition in two groups S and L
Time frame: During surgery
The times of bronchial blocker reposition
The times of bronchial blocker reposition in lateral group and supine group
Time frame: During surgery
The duration of intubation
The duration of intubation, including the time for single-lumen tube intubation, the time for bronchial blocker placement, and the total intubation time (single-lumen tube intubation plus bronchial blocker placement)
Time frame: During surgery
The pressure of ventilation
The pressure of ventilation during mask ventilation, two-lung ventilation (TLV) and one-lung ventilation(OLV)
Time frame: During surgery
Intubation-related complications
Intubation-related complications, including airway injury, dental injury, sore throat, and hoarseness
Time frame: During surgery, after the patient regained full consciousness and before discharge from the post-anesthesia care unit, on the day after surgery, and 2 weeks postoperatively.
Postural injuries
Postural injuries were defined as new-onset injuries not present before surgery but occurring within the first 2 weeks postoperatively, including neuropathies, vasculopathies, and musculoskeletal injuries
Time frame: These complications were assessed at three time points: after the patient regained full consciousness and before discharge from the post-anesthesia care unit, on the day after surgery, and 2 weeks postoperatively.
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Lung collapse grade
When the chest wall was opened, the lung collapse was graded as follows: fully collapsed lung, non-collapsed lung with no visible ventilation, or fully ventilated lung
Time frame: During surgery
Perioperative vital signs
Perioperative vital signs, including mean arterial pressure (MAP), heart rate (HR), and SpO2
Time frame: Immediately after arrival at operating room; Before single lumen tube intubation; After single lumen tube intubation ; One-lung ventilation; Before single lumen tube extubating; 5 minutes after single lumen tube extubating.
Hypoxemia
Hypoxemia was defined as a drop in oxygen saturation (SpO2) below 92%
Time frame: During surgery
The satisfaction scores
The satisfaction scores of patients, nurses and surgeons. Satisfaction scores were used a 0-10 scale (10 = very satisfied).
Time frame: Perioperative period