Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
Anesthesiology. 2013 Mar;118(3):550-61. doi: 10.1097/ALN.0b013e3182834f2d.
Double-lumen tubes (DLTs) or bronchial blockers are commonly used for one-lung ventilation. DLTs are sometimes difficult or even impossible to introduce, and the incidence of postoperative hoarseness and airway injuries is higher. Bronchial blockers are more difficult to position and need more frequent intraoperative repositioning. The design of a Y-shaped bronchial blocker, the EZ-Blocker (Teleflex Life Sciences Ltd., Athlone, Ireland) (EZB), combines some advantages of both techniques. The objective of this study was to assess whether EZB performs clinically better than left-sided DLTs (Broncho-cath; Mallinckrodt, Athlone, Ireland) without causing more injury. Primary outcome was the frequency of initial malpositions.
Eligible patients were adults scheduled for surgery requiring one-lung ventilation who met criteria for placement of both devices. In this parallel trial, 100 consecutive and blinded patients were assigned randomly using a computer-generated list to two groups. The incidence of malposition and ease and time of placement were recorded. Blinded assessors investigated quality of lung deflation, postoperative complaints, and damage to the airway.
Placement of a DLT was unsuccessful twice. The incidence of initial malposition was high and comparable between EZBs (37 of 50) and DLTs (42 of 49) (P = 0.212). Placing single-lumen tubes and EZBs took more time but was rated easier. Quality of lung deflation was comparable. Fewer patients in the EZB group complained of sore throat at day 1. There was a higher incidence of tracheal hematoma and redness and bronchial hematoma in the DLT group.
The EZB is an efficient and effective device for one-lung ventilation and causes less injury and sore throat than a DLT.
双腔管（DLT）或支气管阻塞器常用于单肺通气。有时 DLT 插入困难甚至不可能，术后声音嘶哑和气道损伤的发生率较高。支气管阻塞器定位更困难，需要更频繁的术中重新定位。Y 形支气管阻塞器 EZ-Blocker（Teleflex Life Sciences Ltd.，Athlone，Ireland）（EZB）的设计结合了两种技术的一些优势。本研究旨在评估 EZB 是否在不造成更多损伤的情况下比左侧 DLT（Broncho-cath；Mallinckrodt，Athlone，Ireland）具有更好的临床效果。主要结局是初始位置不正的频率。
符合单肺通气要求并符合两种器械放置标准的手术成年患者为合格患者。在这项平行试验中，100 名连续且盲法患者使用计算机生成的列表随机分为两组。记录位置不正的发生率以及放置的难易程度和时间。盲法评估者调查了肺萎陷的质量、术后投诉以及气道损伤情况。
两次未能放置 DLT。EZB（50 例中的 37 例）和 DLT（49 例中的 42 例）的初始位置不正发生率高且相似（P=0.212）。放置单腔管和 EZB 花费的时间更多，但难度评级较低。肺萎陷质量相似。EZB 组第 1 天咽痛的患者较少。DLT 组气管血肿、红肿和支气管血肿的发生率较高。
EZB 是一种有效的单肺通气装置，与 DLT 相比，造成的损伤和咽痛更少。
