Placement of left-sided double-lumen endobronchial tubes: comparison of clinical and fibreoptic-guided placement.

We have compared a new intubation manoeuvre using a fibreoptic bronchoscope with conventional blind placement of a double-lumen tube. Thirty adult patients who presented for thoracoscopy requiring one-lung ventilation underwent endobronchial intubation with a double-lumen tube inserted either in the conventional blind way or using a fibreoptic bronchoscope. There were four misplacements of the double-lumen tube using the conventional method but none using the bronchoscope. In addition, the bronchoscope allowed more rapid intubation (mean 106 vs 347 s). The results suggest that the fibreoptic-guided method of inserting the double-lumen tube was a satisfactory alternative to the conventional one.