Application of right bronchial occluder in thoracic operation of single lung ventilation
CHEN Jie-yuan，YANG Wei，WANG-Gang，LI Wen-cheng
Chinese Journal of Clinical Anatomy ›› 2016, Vol. 34 ›› Issue (3) : 348-351.
Application of right bronchial occluder in thoracic operation of single lung ventilation
Objective To evaluate the safety and feasibility of the application of bronchial occluder in the right lobe one-lung ventilation in thoracic surgery. Methods From July 2012 to August 2013, 36 consecutive patients who need the right lobe one-lung ventilation in thoracic surgery were enrolled and were randomly divided into two groups: group A and group B, 18 cases in each group. The traditional double lumen bronchial method was used in group A and the bronchial occluder was used in group B intubation time. Changes of vital signsbefore and after intubation,the qualityof lung collapse during operation, pH, arterial partial pressure of CO2, partial pressure of oxygen and airway pressure Paw were recorded 20 min, 40 min,and 60 min after intubation or one-lung ventilation. The number of patients with hypoxia in the operation and postoperative complications in each group were also recorded. Results The airway pressure in group B was significantly lower than that in group A, and the number of patients with postoperative complications such as hypoxia and postoperative hoarseness was significantly lower (P<0.05). Conclusion Bronchialoccluder method could solve intraoperative blood oxygen desaturation caused by the double lumen endobronchial malalignment, and airway irritation was mild. Consequently，it is a safe and effective method for single lung ventilation in the right lobe one-lung ventilation in thoracic surgery.
[1] 孙建良，屠海林，黄冰，等.双腔支气管插管用于胸科手术麻醉分析[J].浙江临床医学，2003,5（5）：391-393.
[2] Cohen E.Con:right-sided double lumen endotracheal tubes should not be routinely used in thoracic surgery [J].Cardiothorac Vasc Anesth, 2002,16(2):249-252.
[3] Anantham D, Jagadesan R, Tiew PE. Clinical review:Independent lung ventilation in critical care[J].Crit Care, 2005, 9(6):594-600.
[4] Gammon RB，Shin MS, Groves RH Jr, et al. Clinical risk factors for pulmonary barotraumas:a multivariate analysi[J].Am J Respir Crit Med,1995,152(4 Pt 1):1235-1240.
[5] 孙传玉，王月兰，李宗民，等.双腔支气管导管位置异常原因分析[J].临床麻醉学杂志，2013, 3(3)：256-258.
[6] 黎阳，温稳剑. 单肺机械通气与肺损伤研究近况[J].中国麻醉与镇痛，2005,7（1）：77-80.
[7] Banihashem N, Alijanpour E, Hasannasab B, et al. Prophylactic effects of lidocaine or beclomethasone spray on post-operative sore throat and cough after orotracheal intubation [J]. Iran J Otorhinolaryngol, 2015, 27(80): 179-184.
[8] Gupta D, Agrawal S, Sharma JP. Evaluation of preoperative Strepsils lozenges on incidence of postextubation cough and sore throat in smokers undergoing anesthesia with endotracheal intubation[J]. Saudi J Anaesth, 2014, 8(2): 244-248.
[9] Safaeian R, Hassani V, Movasaghi G, et al. Postoperative respiratory complications of laryngeal mask airway and tracheal tube in ear, nose and throat operations[J]. Anesth Pain Med, 2015, 5(4): e25111.
[10]Zhong T, Wang W, Chen J, et al. Sore throat or hoarse voice with bronchial blockers or double-lumen tubes for lung isolation:a random-ised, prospective trial[J]. Anaesth Intensive Care, 2009, 37(3):441-446.
[11]Ehrenfeld JM, Walsh JL, Sandberq WS. Right-and left-sided Mallinckrodt double-lumen tubes have identical clinical performance[J]. Anesth Analg, 2008,106(6):1847-1852.
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