Department of Anesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China.
Department of Anesthesiology, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China.
Anaesthesia. 2017 Sep;72(9):1097-1106. doi: 10.1111/anae.13984.
Double-lumen endobronchial tube placement is challenging. This study compared double-lumen tube placement with the Disposcope , a wireless videostylet allowing real-time visualisation, with conventional blind placement. Patients undergoing elective thoracic surgery with normal airways requiring one-lung ventilation were randomly allocated into two groups (27 patients in each group). The Disposcope was used to assist left-sided double-lumen tube placement in one group, and conventional blind placement was performed in the control group. Placement in both groups was checked with fibreoptic bronchoscopy. The Disposcope-assisted group had a shorter total mean (SD) placement time (18.6 (2.5) s vs. 21.4 (2.9) s, p < 0.001), laryngoscopy to end of auscultation time (83.4 (3.0) s vs. 93.9 (5.7) s, p < 0.001) and total operation time (130.7 (6.1) s vs. 154.5 (6.3) s, p < 0.001). In the Disposcope-assisted group, the double-lumen tube was inserted in the correct side in all patients (100.0%), whereas in the conventional group, the double-lumen tube was placed in the correct side in 25 (92.6%) patients and in the wrong side in 2 (7.4%) patients; the difference was not significant (p = 0.150). In the Disposcope-assisted group, the double-lumen tube was inserted to the optimal depth in 24 (88.9%) patients, whereas in the conventional group it was inserted to the optimal depth in one (4.0%) patient. The Disposcope increased the success rate of double-lumen tube placement, and shortened the total operation time when compared with standard placement with confirmation using fibreoptic bronchoscopy, and may replace the conventional method.
双腔支气管导管置管具有挑战性。本研究比较了 Disposcope（一种允许实时可视化的无线视频插管器）引导下的双腔支气管导管置管与传统盲探置管。择期行单侧肺通气的气道正常的胸外科患者被随机分为两组（每组 27 例）。一组使用 Disposcope 辅助左侧双腔支气管导管置管，对照组行常规盲探置管。两组均用纤维支气管镜检查确认置管情况。Disposcope 辅助组的总平均（SD）置管时间（18.6（2.5）s 比 21.4（2.9）s，p<0.001）、喉镜至听诊结束时间（83.4（3.0）s 比 93.9（5.7）s，p<0.001）和总手术时间（130.7（6.1）s 比 154.5（6.3）s，p<0.001）均更短。在 Disposcope 辅助组，所有患者（100.0%）的双腔支气管导管均置入正确侧，而在对照组，25 例（92.6%）患者的双腔支气管导管置入正确侧，2 例（7.4%）患者置入错误侧；差异无统计学意义（p=0.150）。在 Disposcope 辅助组，24 例（88.9%）患者的双腔支气管导管插入到最佳深度，而在对照组，1 例（4.0%）患者插入到最佳深度。与纤维支气管镜确认的标准置管相比，Disposcope 增加了双腔支气管导管置管的成功率，并缩短了总手术时间，可能替代传统方法。
