Extraluminal Placement of the Bronchial Blocker in Infants Undergoing Thoracoscopic Surgery: A Randomized Controlled Study.

OBJECTIVE

The purpose of the present study was to evaluate the efficacy of extraluminal use of the bronchial blocker (BB) for one-lung ventilation (OLV) in infants undergoing thoracoscopic surgery.

DESIGN

This was a prospective, randomized, controlled clinical study.

SETTING

University hospital.

PARTICIPANTS

The study comprised 60 infants undergoing thoracoscopic surgery.

INTERVENTION

The study included 2 groups. A BB was placed extraluminally for OLV in group A, and a single-lumen endobronchial tube was inserted into the desired mainstem bronchus for OLV in group C.

MEASUREMENTS AND MAIN RESULTS

The placement time (4.0 ± 0.6 min v 6.3 ± 4.1 min; p = 0.04) and the number of repositions (2 v 11; p = 0.005) were less in group A. There were significant differences in the heart rate and blood pressure after insertion between the 2 groups (p < 0.05). The tidal volumes and end-tidal pressure of carbon dioxide values 10 minutes after the initiation of OLV were similar between the 2 groups (p > 0.05). The incidence of intraoperative hypoxemia was reduced in group A compared with group C (0% v 20%; p = 0.024). No postoperative adverse events were observed in either group.

CONCLUSIONS

Extraluminal use of the BB may provide a solution for a rapid placement and excellent quality of lung isolation, and it may reduce the incidence of intraoperative hypoxemia in infants without increasing the incidence of hoarseness.