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Luo K, Chen K, Li Y, Ji Y. Clinical evaluation of laryngeal mask airways in video-assisted thoracic surgery: a meta-analysis of randomized controlled trials. J Cardiothorac Surg 2024; 19:361. [PMID: 38915035 PMCID: PMC11194903 DOI: 10.1186/s13019-024-02840-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 06/14/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Endotracheal intubation is often associated with postoperative complications such as sore throat discomfort and hoarseness, reducing patient satisfaction and prolonging hospital stays. Laryngeal mask airway (LMA) plays a critical role in reducing airway complications related to endotracheal intubation. This meta-analysis was performed to determine the efficacy and safety of LMA in video-assisted thoracic surgery (VATS). METHODS The PubMed, Embase, Cochrane Library, Medline and Web of Science databases were searched for eligible studies from inception until October 5, 2023. Cochrane's tool (RoB 2) was used to evaluate the possibility biases of RCTs. We performed sensitivity analysis and subgroup analysis to assess the robustness of the results. RESULTS Seven articles were included in this meta-analysis. Compared with endotracheal intubation, there was no significant difference in the postoperative hospital stay (SMD = -0.47, 95% CI = -0.98-0.03, P = 0.06), intraoperative minimum SpO2 (SMD = 0.00, 95% CI = -0.49-0.49, P = 1.00), hypoxemia (RR = 1.00, 95% CI = 0.26-3.89, P = 1.00), intraoperative highest PetCO2 (SMD = 0.51, 95% CI = -0.12-1.15, P = 0.11), surgical field satisfaction (RR = 1.01, 95% CI = 0.98-1.03, P = 0.61), anesthesia time (SMD = -0.10, 95% CI = -0.30-0.10, P = 0.31), operation time (SMD = 0.06, 95% CI = -0.13-0.24, P = 0.55) and blood loss (SMD =- 0.13, 95% CI = -0.33-0.07, P = 0.21) in LMA group. However, LMA was associated with a lower incidence of throat discomfort (RR = 0.28, 95% CI = 0.17-0.48, P < 0.00001) and postoperative hoarseness (RR = 0.36, 95% CI = 0.16-0.81, P = 0.01), endotracheal intubation was found in connection with a longer postoperative awake time (SMD = -2.19, 95% CI = -3.49 - -0.89, P = 0.001). CONCLUSION Compared with endotracheal intubation, LMA can effectively reduce the incidence of throat discomfort and hoarseness post-VATS, and can accelerate the recovery from anesthesia. LMA appears to be an alternative to endotracheal intubation for some specific thoracic surgical procedures, and the efficacy and safety of LMA in VATS need to be further explored in the future.
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Affiliation(s)
- Kai Luo
- Department of Anesthesiology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Kaiming Chen
- Department of Anesthesiology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yu Li
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yang Ji
- Department of Anesthesiology, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Xiao H, Zhang H, Pan J, Yue F, Zhang S, Ji F. Effect of lung isolation with different airway devices on postoperative pneumonia in patients undergoing video-assisted thoracoscopic surgery: a propensity score-matched study. BMC Pulm Med 2024; 24:165. [PMID: 38575884 PMCID: PMC10996232 DOI: 10.1186/s12890-024-02956-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/07/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Postoperative pneumonia is one of the common complications after video-assisted thoracoscopic surgery. There is no related study on the effect of lung isolation with different airway devices on postoperative pneumonia. Therefore, in this study, the propensity score matching method was used to retrospectively explore the effects of different lung isolation methods on postoperative pneumonia in patients undergoing video-assisted thoracoscopic surgery. METHODS This is A single-center, retrospective, propensity score-matched study. The information of patients who underwent VATS in Weifang People 's Hospital from January 2020 to January 2021 was retrospectively included. The patients were divided into three groups according to the airway device used in thoracoscopic surgery: laryngeal mask combined with bronchial blocker group (LM + BB group), tracheal tube combined with bronchial blocker group (TT + BB group) and double-lumen endobronchial tube group (DLT group). The main outcome was the incidence of pneumonia within 7 days after surgery; the secondary outcome were hospitalization time and hospitalization expenses. Patients in the three groups were matched using propensity score matching (PSM) analysis. RESULTS After propensity score matching analysis, there was no significant difference in the incidence of postoperative pneumonia and hospitalization time among the three groups (P > 0.05), but there was significant difference in hospitalization expenses among the three groups (P < 0.05). CONCLUSIONS There was no significant difference in the effect of different intubation lung isolation methods on postoperative pneumonia in patients undergoing thoracoscopic surgery.
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Affiliation(s)
- Hongyi Xiao
- Department of Anesthesiology, Weifang People's Hospital, Kuiwen District, No. 151 Guangwen Street, Weifang, 261041, China
| | - Huan Zhang
- Department of Anesthesiology, Weifang People's Hospital, Kuiwen District, No. 151 Guangwen Street, Weifang, 261041, China
| | - Jiying Pan
- Department of Anesthesiology, Weifang People's Hospital, Kuiwen District, No. 151 Guangwen Street, Weifang, 261041, China.
| | - Fangli Yue
- Department of Anesthesiology, Weifang People's Hospital, Kuiwen District, No. 151 Guangwen Street, Weifang, 261041, China
| | - Shuwen Zhang
- Department of Anesthesiology, Weifang People's Hospital, Kuiwen District, No. 151 Guangwen Street, Weifang, 261041, China
| | - Fanceng Ji
- Department of Anesthesiology, Weifang People's Hospital, Kuiwen District, No. 151 Guangwen Street, Weifang, 261041, China.
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Nakanishi T, Sento Y, Kamimura Y, Nakamura R, Hashimoto H, Okuda K, Nakanishi R, Sobue K. Combined use of the ProSeal laryngeal mask airway and a bronchial blocker vs. a double-lumen endobronchial tube in thoracoscopic surgery: A randomized controlled trial. J Clin Anesth 2023; 88:111136. [PMID: 37137259 DOI: 10.1016/j.jclinane.2023.111136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/16/2023] [Accepted: 04/25/2023] [Indexed: 05/05/2023]
Abstract
STUDY OBJECTIVE The combined use of the ProSeal laryngeal mask airway and a bronchial blocker may reduce postoperative hoarseness and sore throat. We aimed to test the feasibility and efficacy of this combination technique in thoracoscopic surgery. DESIGN A single-center, patient-assessor blinded, randomized controlled trial. SETTING Nagoya City University Hospital (between November 2020 and April 2022). PATIENTS A total of 100 adult patients undergoing lobectomy or segmentectomy by video- or robotic-assisted thoracoscopic surgery. INTERVENTIONS Patients were randomly assigned to either group using a combination of the ProSeal laryngeal mask airway and a bronchial blocker (pLMA+BB group) or a double-lumen endobronchial tube (DLT group). MEASUREMENTS The primary outcome was the hoarseness incidence on 1-3 postoperative days. Secondary outcomes included sore throat, intraoperative complications (hypoxemia, hypercapnia, surgical interruption, malposition of devices, unintended lung expansion, and ventilatory difficulty), lung collapse, device placement-related outcomes, and coughing during emergence. MAIN RESULTS A total of 100 patients underwent randomization (51 to the pLMA+BB group and 49 to the DLT group). After drop outs, a total of 49 patients in each group were analyzed per-protocol. The incidences of hoarseness in the pLMA+BB and DLT groups were 42.9% and 53.1% (difference, -10.2%; 95% confidence interval, -30.1% to 10.3%; p = 0.419), 18.4% vs. 32.7%, and 20.4% vs. 24.5% on postoperative day 1, 2, and 3, respectively. The incidences of sore throat in the pLMA+BB and DLT groups were 16.3% vs. 34.7% (difference, -18.4%; 95% confidence interval, -35.9% to -0.9%; p = 0.063) on postoperative day 1. In the pLMA+BB group, more intraoperative complications and less coughing during emergence were observed compared to the DLT group. Lung collapse and placement-related outcomes were comparable between the groups. CONCLUSIONS The combination of ProSeal laryngeal mask airway and bronchial blocker did not significantly reduce hoarseness compared to the double-lumen endobronchial tube.
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Affiliation(s)
- Toshiyuki Nakanishi
- Department of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan.
| | - Yoshiki Sento
- Department of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan
| | - Yuji Kamimura
- Department of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan
| | - Ryuji Nakamura
- Department of Thoracic and Pediatric Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan
| | - Hiroya Hashimoto
- Clinical Research Management Center, Nagoya City University Hospital, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan
| | - Katsuhiro Okuda
- Department of Thoracic and Pediatric Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan
| | - Ryoichi Nakanishi
- Department of Thoracic and Pediatric Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan
| | - Kazuya Sobue
- Department of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan
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Lv J, Ding X, Zhao J, Zhang H, He J, Ma L, Lv J. A combination of supraglottic airway and bronchial blocker for one-lung ventilation in infants undergoing thoracoscopic surgery. Heliyon 2023; 9:e13576. [PMID: 36846679 PMCID: PMC9950831 DOI: 10.1016/j.heliyon.2023.e13576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 01/20/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
Objectives One-lung ventilation (OLV) for children under the age of two years is difficult. The authors hypothesize that a combination of a supraglottic airway (SGA) device and intraluminal placement of a bronchial blocker (BB) may provide an appropriate choice. Design A prospective method-comparison study. Setting Second Affiliated Hospital of Xi'an Jiaotong University, China. Participants 120 patients under the age of two years undergoing thoracoscopic surgery with OLV. Interventions Participants were randomly assigned to receive intraluminal placement of BB with SGA (n = 60) or extraluminal placement of BB with endotracheal tube (ETT) (n = 60) for OLV. Measurements and main results The primary outcome was the length of postoperative hospitalization stay. The secondary outcomes were the basic parameters of OLV and investigator-defined severe adverse events. The postoperative hospitalization stay was 6 days (interquartile range, IQR 4-9) in SGA plus BB group compared with 9 days (IQR 6-13) in ETT plus BB group (P = 0.034). The placement and positioning duration of SGA plus BB was 64 s (IQR 51-75) compared with 132 s (IQR 117-152) of ETT plus BB (P = 0.001). The values of leukocyte (WBC) and C-reactive protein (CRP) of SGA plus BB group on the first day of post-operation were 9.8 × 109/L (IQR 7.4-14.5) and 15.1 mg/L (IQR 12.5-17.3) compared with 13.6 × 109/L (IQR 10.8-17.1) and 19.6 mg/L (IQR 15.0-23.5) of ETT plus BB group (P = 0.022 and P = 0.014). Conclusion There were few if any significant adverse events in the intervention group (SGA plus BB) for OLV in children under the age of two years, and this method seems worthy of clinical application. Meanwhile, the mechanism for this novel technique to shorten the length of postoperative hospitalization stay needs to be further explored.
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Affiliation(s)
- Junlin Lv
- Department of Anesthesiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiaoying Ding
- Department of Anesthesiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jing Zhao
- Department of Anesthesiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Huijuan Zhang
- Department of Anesthesiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jiaojiao He
- Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Lei Ma
- Department of Anesthesiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China,Corresponding author. Department of Anesthesiology, Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 Xiwu Road, Xi'an, Shaanxi, China.
| | - Jianrui Lv
- Department of Anesthesiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China,Corresponding author. Department of Anesthesiology, Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 Xiwu Road, Xi'an, Shaanxi, China.
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Parab S, Sarangi A, Singh S. Bronchial blocker through Proseal LMA – A useful approach for paediatric lung isolation. Indian J Anaesth 2022; 66:537-538. [PMID: 36111091 PMCID: PMC9468992 DOI: 10.4103/ija.ija_63_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/17/2022] [Accepted: 07/05/2022] [Indexed: 11/20/2022] Open
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Abstract
This review discusses the present strategies in lung separation, the various types of double-lumen tubes (DLTs), and the use of bronchial blockers (BBs). Methods of selecting the correct DLT size and the role of videolaryngoscopy in placing a DLT are reviewed. Mechanisms whereby inhaled anesthetics may be protective during one-lung ventilation (OLV) are highlighted. The risk and prevention of fire during thoracic procedures are discussed.
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Affiliation(s)
- Edmond Cohen
- From the Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
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Nakanishi T, Toriumi T. A Novel Method to Overcome Technical Problems With a Combination of Laryngeal Mask Airway and Bronchial Blocker in Thoracic Surgery. J Cardiothorac Vasc Anesth 2021; 35:3453-3454. [PMID: 33810935 DOI: 10.1053/j.jvca.2021.02.063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 02/25/2021] [Accepted: 02/28/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Toshiyuki Nakanishi
- Department of Anesthesiology, Japan Community Healthcare Organization, Tokuyama Central Hospital, Yamaguchi, Japan
| | - Takashi Toriumi
- Department of Anesthesiology, Japan Community Healthcare Organization, Tokuyama Central Hospital, Yamaguchi, Japan
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Li XL, He XB, Wan L, Liu CQ, Cui Y. Comparison of tracheal intubation with controlled ventilation and laryngeal mask airway with spontaneous ventilation for thoracoscopic bullectomy. Medicine (Baltimore) 2020; 99:e19704. [PMID: 32311952 PMCID: PMC7440194 DOI: 10.1097/md.0000000000019704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
General anesthesia with double-lumen endobronchial intubation is considered mandatory for thoracoscopic bullectomy. We assessed the safety and feasibility of thoracoscopic bullectomy for treatment of primary spontaneous pneumothorax (PSP) under intubating laryngeal mask airway (ILMA) with spontaneous breathing sevoflurane anesthesia combined with thoracic paravertebral block (TPB).From January 2018 to December 2018, some 34 consecutive patients with PSP were treated by thoracoscopic bullectomy under ILMA with spontaneous breathing sevoflurane anesthesia combined with TPB (study group). To evaluate the safety and feasibility of this new technique, these patients were compared with the control group consisting of 34 consecutive patients with PSP who underwent thoracoscopic bullectomy using tracheal intubation with controlled ventilation from January 2017 to December 2017. The demographic characteristics, intraoperative surgical and anesthetic results, and postoperative results were assessed.The 2 groups had comparable anesthetic time, operation time, chest drainage time, postoperative hospital stays, and hospitalization cost. Visual analogue score (VAS) scores at 3 hours at rest and at coughing were significantly lower in the study group than in the control group (mean, 0.9 vs 2.0 and 1.8 vs 4.0, P = .024 and P = .006, respectively). No differences were seen in PaO2 values between the 2 groups in the intraoperative stage and postoperative stage (P > .05, respectively). The pH value was significantly lower in the intraoperative stage (mean, 7.28 vs 7.40, P = .01) and higher in the postoperative stage (mean, 7.35 vs 7.33, P = .014) in the study group than in the control group. The PaCO2 value was significantly higher in the intraoperative stage in the study group than in the control group (mean, 57.0 mm Hg vs 42.0 mm Hg, P = .015). In the study group, no cough reflex was found, and the level of collapse of the operative lung was excellent in 31 cases and good in 3 cases.Our study demonstrated that thoracoscopic bullectomy for treatment of PSP can be safely and feasibly performed in highly selected patients under ILMA with spontaneous breathing sevoflurane anesthesia combined with TPB.
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Affiliation(s)
- Xiu-Liang Li
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiang-Bo He
- Psychology, Indiana University Bloomington, Bloomington, Indiana, USA
| | - Lei Wan
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Chun-Quan Liu
- Department of Thoracic Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yong Cui
- Department of Thoracic Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Zhang ZJ, Zheng ML, Nie Y, Niu ZQ. Comparison of Arndt-endobronchial blocker plus laryngeal mask airway with left-sided double-lumen endobronchial tube in one-lung ventilation in thoracic surgery in the morbidly obese. ACTA ACUST UNITED AC 2017; 51:e6825. [PMID: 29267506 PMCID: PMC5734186 DOI: 10.1590/1414-431x20176825] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 10/16/2017] [Indexed: 11/22/2022]
Abstract
This study aimed to evaluate the feasibility and performance of Arndt-endobronchial blocker (Arndt) combined with laryngeal mask airway (LMA) compared with left-sided double-lumen endobronchial tube (L-DLT) in morbidly obese patients in one-lung ventilation (OLV). In a prospective, randomized double-blind controlled clinical trial, 80 morbidly obese patients (ASA I-III, aged 20-70) undergoing general anesthesia for elective thoracic surgeries were randomly allocated into groups Arndt (n=40) and L-DLT (n=40). In group Arndt, a LMA™ Proseal was placed followed by an Arndt-endobronchial blocker. In group L-DLT, patients were intubated with a left-sided double-lumen endotracheal tube. Primary endpoints were the airway establishment, ease of insertion, oxygenation, lung collapse and surgical field exposure. Results showed similar ease of airway establishment and tube/device insertion between the two groups. Oxygen arterial pressure (PaO2) of patients in the Arndt group was significantly higher than L-DLT (154±46 vs 105±52 mmHg; P<0.05). Quality of lung collapse and surgical field exposure in the Arndt group was significantly better than L-DLT (effective rate 100 vs 90%; P<0.05). Duration of surgery and anesthesia were significantly shorter in the Arndt group (2.4±1.7 vs 3.1±1.8 and 2.8±1.9 vs 3.8±1.8 h, respectively; P<0.05). Incidence of hoarseness of voice and incidence and severity of throat pain at the post-anesthesia care unit and 12, 24, 48, and 72 h after surgery were significantly lower in the Arndt group (P<0.05). Findings suggested that Arndt-endobronchial blocker combined with LMA can serve as a promising alternative for morbidly obese patients in OLV in thoracic surgery.
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Affiliation(s)
- Z J Zhang
- Department of Anesthesiology, the Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - M L Zheng
- Department of Anesthesiology, the Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Y Nie
- Department of Anesthesiology, the Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Z Q Niu
- Department of Anesthesiology, the Cangzhou Central Hospital, Cangzhou, Hebei, China
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Du X, Mao S, Cui J, Ma J, Zhang G, Zheng Y, Zhou H, Xie L, Zhang D, Shi R, Chen G. Use of laryngeal mask airway for non-endotracheal intubated anesthesia for patients with pectus excavatum undergoing thoracoscopic Nuss procedure. J Thorac Dis 2016; 8:2061-7. [PMID: 27621860 DOI: 10.21037/jtd.2016.07.52] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The aim of the present study was to determine the safety and feasibility of the use of laryngeal mask airway (LMA) for non-endotracheal intubated anesthesia for patients with pectus excavatum (PE) undergoing thoracoscopic Nuss procedure. METHODS Between July 2015 and December 2015, 30 selected patients with PE were planned to undergo a thoracoscopic Nuss procedure using LMA for non-endotracheal intubated anesthesia in the Guangdong General Hospital. The clinical data were analyzed to evaluate the safety and feasibility of this technique. RESULTS Of the 30 selected patients, two were female, the mean age was 16.04±5.09 years and the average Haller index was 3.37±0.88. A total of 27 cases (90%) succeeded at the first attempt, one patient required conversion to an endotracheal tube (ETT) because of continuous air leak. The peripheral O2 saturation (SpO2), end-tidal carbon dioxide (EtCO2) values, heart rate (HR), and mean arterial blood pressure (MAP) remained stable throughout the procedure in all cases. All of the 30 patients were successfully corrected without requiring conversion to an open surgery. Two patients experienced postoperative nausea and one reported a sore throat. Neither gastro-esophageal reflux nor in-hospital mortality occurred. CONCLUSIONS The use of LMA for non-endotracheal intubated anesthesia for selected patients with PE undergoing thoracoscopic Nuss procedure is clinically safe and technically feasible.
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Affiliation(s)
- Xiaojun Du
- Southern Medical University, Guangzhou 510515, China;; Department of Thoracic Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Songsong Mao
- Department of Anesthesia, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Jianxiu Cui
- Department of Anesthesia, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Jue Ma
- Department of Anesthesia, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Guangyan Zhang
- Department of Anesthesia, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Yong Zheng
- Department of Anesthesia, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Haiyu Zhou
- Department of Thoracic Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Liang Xie
- Department of Thoracic Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Dongkun Zhang
- Department of Thoracic Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Ruiqing Shi
- Department of Thoracic Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Gang Chen
- Department of Thoracic Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
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Liang P, Ni J, Zhou C, Yu H, Liu B. Efficacy of a New Blind Insertion Technique of Arndt Endobronchial Blocker for Lung Isolation: Comparison With Conventional Bronchoscope-Guided Insertion Technique-A Pilot Study. Medicine (Baltimore) 2016; 95:e3687. [PMID: 27175708 PMCID: PMC4902550 DOI: 10.1097/md.0000000000003687] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
This study aimed to find other methods of blind insertion of Arndt endobronchial blocker (AEB) for lung isolation when a fiberoptic bronchoscope (FOB) is unavailable.We compared the effectiveness and safety of 3 insertion techniques of AEB: Gum elastic bougie (GEB)-, bougie combined with cricoid displacing (BCD)-, and fiberoptic bronchoscope (FOB)-guided insertion. Seventy-eight patients undergoing esophageal procedure and requiring left thoracotomy were randomly assigned to 1 of 3 groups: GEB group, BCD group, and FOB group. We recorded the successful placement of AEBs at first attempt, placement time, malposition of AEBs in supine and lateral decubitus position, the bronchus injury score, and other complications.The successful placement of AEB for the first attempt was 22/26, 25/26, and 26/26 patients in GEB, BCD, and FOB groups, respectively. The placement times in GEB and BCD groups were longer than those in the FOB group (P < 0.05). AEB malposition occurred in 1/26, 2/26, 1/26 patients after lateral decubitus position, and AEBs were repositioned in 5/26, 3/26, 1/26 patients by FOB due to poor lung isolation in GEB, BCD, and FOB groups, respectively. There was no difference for the bronchus injury scores and other complications among 3 groups (P > 0.05).Bougie and cricoid displacing-guided blind insertion of AEB seems to be a novel method, which is an effective and safe alternative when FOB was unavailable.
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Affiliation(s)
- Peng Liang
- From the Department of Anesthesiology (PL, HY, BL), Laboratory of Anesthesia & CCM, Translational Neuroscience Center (CZ), West China Hospital, Sichuan University; Department of Anesthesiology, West China Second Hospital, Sichuan University (JN); Chengdu, Sichuan, China
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