Abstract: Objective: To evaluate the efficacy of I-Gel laryngeal mask combined with endotracheal tube/ bronchial blocker in patients undergoing esophageal cancer
radical prostatectomy for one-lung ventilation. Methods: sixty patients aged 40 to 80 years old, ASAⅠ~Ⅲ, undergoing selective esophageal cancer radical surgery, were randomly divided into three groups(n=30): double-lumen tube group, endotracheal tube with bronchial blocker group (B group), I-Gel laryngeal mask with endotracheal tube and bronchial blocker (I group). The variables were recorded including the time required to achieve the optimal positioning of the device, efficiency of lung collapse and perioperative malposition frequency of double-lumen tubes/ bronchial blockers and the airway pressure(PAW) during one-lung ventilation. The blood pressure and heart rate were recorded before anesthesia, immediately before induction, 1 minute and 5 minutes after intubation, 5 minute before extubation and 1 minute, 5 minutes after extubation(T0-6). The complications of bucking during extubation and pharyngalgia and hoarseness in two days after the surgery were recorded. Results: No obvious fluctuation of BP and HR were seen in I group during the period of induction and extubation except the time of T1(SBP: 117±9 vs 145±12; DBP:65±9 vs75±9, P<0.05). The BP and HR at the time of T2-6 in D Group and B group were high than the baseline (To). The bucking frequency during extubationand pharyngalgia/hoarseness in two days after the surgery in B group and D group were high than I group (0 vs 8,15, P<0.05) (0 vs16,7, P<0.05 ). The positioning time of I group was longer than B group and D Group’s(4.2±1.2 vs 2.8±0.7,2.7±0.4 ) (P<0.05). There were no significant difference in efficiency of lung collapse (8.9±1.2,8.35±1.3,8.4±1.3) (P>0.05) and perioperative malposition frequency of double-lumen tubes/ bronchial blockers between I Group, D Group and B group(4,2,3) (P>0.05). The PAW of D Group was higher than I group’s and B group’s (22±3,21±4 vs 28±4) (P>0.05). Conclusion:I-Gel laryngeal mask with endotracheal tube and bronchial blocker can decrease stimulation of the induction and revival period in full anesthesia, can safely used in in patients undergoing esophageal cancer radical prostatectomy for one-lung ventilation.
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