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Lee S, Han SJ, Park J, Kim YH, Hong B, Oh C, Yoon SH. A Comparison of Conventional Rotating Method and Non-Rotating Method for Double-Lumen Tube Insertion Using a Customized Rigid J-Shaped Stylet for One-Lung Ventilation: A Randomized Controlled Trial. J Clin Med 2024; 13:5302. [PMID: 39274515 PMCID: PMC11396204 DOI: 10.3390/jcm13175302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Revised: 09/02/2024] [Accepted: 09/04/2024] [Indexed: 09/16/2024] Open
Abstract
Background: The conventional double-lumen tube (DLT) insertion method requires a rotatory maneuver that was developed using direct laryngoscopy and may not be optimal for video laryngoscopy. This study compared a new non-rotatory maneuver with the conventional method for DLT insertion using video laryngoscopy. Methods: Patients scheduled for thoracic surgery requiring one-lung ventilation were randomly assigned to either the rotating (R) or non-rotating (NR) method groups. All patients were intubated using a customized rigid J-shaped stylet, a video laryngoscope, and a left-sided silicone DLT. The conventional rotatory maneuver was performed in the R group. In the NR group, the stylet was inserted with its tip oriented anteriorly (12 o'clock direction) while maintaining the bronchial lumen towards the left (9 o'clock direction). After reaching the glottic opening, the tube was inserted using a non-rotatory maneuver, maintaining the initial orientation. The primary endpoint was the intubation time. Secondary endpoints included first-trial success rate, sore throat, hoarseness, and airway injury. Results: Ninety patients (forty-five in each group) were included. The intubation time was significantly shorter in the NR group compared to the R group (22.0 [17.0, 30.0] s vs. 28.0 [22.0, 34.0] s, respectively), with a median difference of 6 s (95% confidence interval [CI], 3-11 s; p = 0.017). The NR group had a higher first-attempt success rate and a lower incidence of sore throats. Conclusions: The non-rotatory technique with video laryngoscopy significantly reduced intubation time and improved first-attempt success rate, offering a viable and potentially superior alternative to the conventional rotatory technique.
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Affiliation(s)
- Soomin Lee
- Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea
| | - Sung Joon Han
- Department of Thoracic and Cardiovascular Surgery, College of Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea
| | - Jiho Park
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea
- Department of Anesthesiology and Pain Medicine, Sejong Chungnam National University Hospital, Sejong 30099, Republic of Korea
| | - Yoon-Hee Kim
- Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea
| | - Boohwi Hong
- Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea
| | - Chahyun Oh
- Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea
| | - Seok-Hwa Yoon
- Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea
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Syal R, Kumar R, Chhabra S, Kamal M. Cuff inflation technique: A saviour in the double lumen tube placement. J Clin Anesth 2021; 74:110364. [PMID: 34147930 DOI: 10.1016/j.jclinane.2021.110364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/20/2021] [Accepted: 05/23/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Rashmi Syal
- Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur 342005, India.
| | - Rakesh Kumar
- Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur 342005, India.
| | - Swati Chhabra
- Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur 342005, India.
| | - Manoj Kamal
- Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur 342005, India.
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Reply to: two-handed jaw thrust in patients undergoing intubation with a double-lumen endobronchial tube. Eur J Anaesthesiol 2021; 38:185-186. [PMID: 33394786 DOI: 10.1097/eja.0000000000001307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Essandoh M, Andritsos M. Double-Lumen Endotracheal Tube Placement: Knowing Depth of Insertion Firsthand May Make a Difference. J Cardiothorac Vasc Anesth 2018; 32:860-862. [DOI: 10.1053/j.jvca.2017.11.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Indexed: 11/11/2022]
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Kendall MC, Robbins ZM, Cohen A, Minn M, Benzuly SE, Triebwasser AS, McCormick ZL, Gorgone M. Selected highlights in clinical anesthesia research. J Clin Anesth 2017; 43:90-97. [DOI: 10.1016/j.jclinane.2017.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 10/10/2017] [Accepted: 10/13/2017] [Indexed: 12/17/2022]
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