Abstract: Objective To evaluate the feasibility and advantages of combined bronchial tube in one⁃lung ventilation (OLV) in adult patients undergoing thoracic surgery. Methods A total of 60 adult patients who were scheduled for thoracic surgery with OLV were divided into two groups, according to the random number table method (n=30): a double lumen endobronchial tube (DLT) group (group D) and a combined bronchial tube group (group C). All patients underwent anesthesia induction according to the unified standard. After induction, patients in group D were inserted with DLT, while those in group C were inserted with combined bronchial tube. Their anesthesia maintenance followed the same regimen. After the end of the operation, patients in group D were resuscitated and the DLT was removed. For group C, the endotracheal tube was removed after OLV, while the external tracheal tube was removed after resuscitation. Then, their mean arterial pressure (MAP) and heart rate before anesthesia (T0), before intubation (T1), 1 min (T2) and 5 min (T3) after intubation, before extubation (T4), 1 min (T5) and 5 min (T6) after extubation were recorded. Furthermore, position changes under a fiberoptic bronchoscope, the time from intubation to alignment, airway pressure and the minimum pulse oxygen saturation (SpO2) during one‑lung/double lung ventilation were recorded. The results of lung collapse, injury of oral cavity or airway, and airway related adverse events within postoperative 24 h were recorded. Results MAP and heart rate in group D were higher than those in group C at T2, T4 and T5 (P<0.05). There was no statistical difference in airway pressure and the minimum SpO2 during one‑lung/double lung ventilation, lung collapse and the incidence of oral cavity and airway injury between the two groups (P>0.05). The percentage of position change under a fiberoptic bronchoscope, the time from intubation to alignment, and the incidence of postoperative airway related adverse events in group C were lower than those in group D (P<0.05). Conclusions Combined bronchial catheter is a new type of catheter which can well realize OLV in adult patients undergoing thoracic surgery. Furthermore, it has advantages of less circulatory fluctuation, lower difficulty from intubation to alignment and less airway related adverse events than DLT.
|