Airway injuries after one-lung ventilation: a comparison between double-lumen tube and endobronchial blocker: a randomized, prospective, controlled trial.

Abstract

BACKGROUND:

Vocal cord injuries, postoperative hoarseness, and sore throat are common complications after general anesthesia. One-lung ventilation can be achieved via two techniques: double-lumen endotracheal tube or endobronchial blocker such as the Arndt blocker. The current study was designed to assess the impact of these techniques for one-lung ventilation on the incidence and severity of postoperative hoarseness, vocal cord lesions, and sore throat.

METHODS:

In this prospective trial, 60 patients were randomly assigned to two groups. One-lung ventilation was achieved with either an endobronchial blocker (blocker group) or a double-lumen-tube (double-lumen group). Postoperative hoarseness and sore throat were assessed at 24, 48, and 72 h after surgery. Bronchial injuries and vocal cord lesions were examined by bronchoscopy immediately after surgery.

RESULTS:

In 56 included patients, postoperative hoarseness occurred significantly more frequently in the double-lumen group compared with the blocker group: 44% versus 17%, respectively (P = 0.046). Similar findings were observed for vocal cord lesions: 44% versus 17%, respectively (P = 0.046). The incidence of bronchial injuries was comparable between groups (P = 0.540). Cumulative number of days with hoarseness and sore throat were significantly increased in the double-lumen group compared with the blocker group (P < 0.01). No major complications such as bronchial ruptures were observed.

CONCLUSIONS:

Clinicians should be aware of an increased incidence of minor airway injuries that may impair patient satisfaction when using a double-lumen tube instead of an endobronchial blocker for one-lung ventilation.

• Authors: Heike Knoll, Stephan Ziegeler, Jan-Uwe Schreiber, Heiko Buchinger, Patric Bialas, Kirill Semyonov, Thomas Graeter, Thomas Mencke
• Journal: Anesthesiology (Anesthesiology) Vol. 105 Issue 3 Pg. 471-7 (Sep 2006) ISSN: 0003-3022 [Print] United States
• PMID: 16931978 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Topics

• Adult
• Aged
• Bronchi (injuries)
• Bronchoscopy
• Female
• Hoarseness (etiology)
• Humans
• Intubation, Intratracheal (adverse effects, instrumentation)
• Male
• Middle Aged
• Pharyngitis (etiology)
• Prospective Studies
• Respiration, Artificial (adverse effects)
• Vocal Cords (injuries)