A comparison of the deflecting-tip bronchial blocker with a wire-guided blocker or left-sided double-lumen tube.

OBJECTIVE

To compare a new bronchial blocker, the Cohen blocker, with the Arndt blocker and a left double-lumen tube (DLT).

DESIGN

A prospective, randomized, controlled trial.

SETTING

University hospital.

PARTICIPANTS

Forty-eight patients undergoing lung surgery.

INTERVENTION

Intubation with 1 of the 3 devices. Comparisons among groups included (1) time for initial positioning, (2) degree of lung collapse at pleura opening, and (3) number of intraoperative fiberoptic examinations.

MEASUREMENTS AND MAIN RESULTS

Positioning of the Cohen blocker (256 [166-341] seconds; median [interquartile range]) took no longer compared with the Arndt blocker (253 [184-305] seconds), and there was a trend toward difference between the 2 blockers and the DLT (137 [102-199] seconds) (p = 0.07). The time to place the Cohen blocker was longer in cases of left bronchus occlusion compared with a right one (340 [300-450] v 170 [124-259] seconds, p = 0.02); they were similar in the Arndt group. The degree of lung collapse was different among groups (p = 0.05), but the difference between any pair did not reach statistical significance. The number of patients who required at least 1 additional FOB examination was not statistically different (50% of patients in each blocker group v 19% in the DLT group).

CONCLUSIONS

There was a trend toward a difference between times to place a bronchial blocker and the DLT. The Cohen blocker is more difficult to position in the left main bronchus than in the right one.