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Effects of bronchial blockers on one-lung ventilation in general anesthesia: A randomized controlled trail.
Medicine (Baltimore) 2019; 98(41):e17387M

Abstract

BACKGROUND

Double-lumen bronchial tubes (DLBT) and bronchial blockers (BB) are commonly used in the anesthesia for clinical thoracic surgery. But there are few systematic clinical comparisons between them. In this study, the effects of BB and DLBT on one-lung ventilation (OLV) are studied.

METHODS

The 200 patients with thoracic tuberculosis undergoing thoracic surgery, were randomly assigned to group A (DLBT) and group B (BB). Intubation time, hemodynamic changes (mean arterial pressure [MAP], heart rate [HR]), and arterial blood gas indicators (arterial partial pressure of carbon dioxide [PaCO2], arterial partial pressure of oxygen [PaO2], airway plateau pressure [Pplat], and airway peak pressure [Ppeak]) at 4 time points were recorded. Complications such as hoarseness, pulmonary infection, pharyngalgia, and surgical success rate were also evaluated postoperatively.

RESULTS

Intubation times were shorter in group B. Both MAP and HR in group A were significantly higher 1 minute after intubation than before, but also higher than those in group B. PaO2 levels were lower in both groups during (OLV) than immediately after anesthesia and after two-lung ventilation (TLV), with PaO2 being lower after 60 minutes of OLV than after 20 minutes of OLV. Furthermore, at both points during OLV, PaO2 was lower in group A than in group B. No significant differences in PaCO2 were found between the 2 groups. Ppeak and Pplat were increased in both groups during OLV, with both being higher in group A than in group B. The incidence of postoperative hoarseness, pulmonary infection, and pharyngalgia were lower in group B. There was no significant difference in the success rate of operation between the 2 groups.

CONCLUSIONS

Compare with using DLBT, implementation of BB in general anesthesia has less impact on hemodynamics, PaO2 and airway pressures, and achieves lower incidence of postoperative complication.

Authors+Show Affiliations

Department of Anesthesiology, Cangzhou Central Hospital, Cangzhou, Hebei Province, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

31593088

Citation

Zheng, Mengliang, et al. "Effects of Bronchial Blockers On One-lung Ventilation in General Anesthesia: a Randomized Controlled Trail." Medicine, vol. 98, no. 41, 2019, pp. e17387.
Zheng M, Niu Z, Chen P, et al. Effects of bronchial blockers on one-lung ventilation in general anesthesia: A randomized controlled trail. Medicine (Baltimore). 2019;98(41):e17387.
Zheng, M., Niu, Z., Chen, P., Feng, D., Wang, L., Nie, Y., ... Shan, S. (2019). Effects of bronchial blockers on one-lung ventilation in general anesthesia: A randomized controlled trail. Medicine, 98(41), pp. e17387. doi:10.1097/MD.0000000000017387.
Zheng M, et al. Effects of Bronchial Blockers On One-lung Ventilation in General Anesthesia: a Randomized Controlled Trail. Medicine (Baltimore). 2019;98(41):e17387. PubMed PMID: 31593088.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of bronchial blockers on one-lung ventilation in general anesthesia: A randomized controlled trail. AU - Zheng,Mengliang, AU - Niu,Zhiqiang, AU - Chen,Peng, AU - Feng,Dawei, AU - Wang,Lei, AU - Nie,Yu, AU - Wang,Benqing, AU - Zhang,Zhijun, AU - Shan,Shiqiang, PY - 2019/10/9/entrez PY - 2019/10/9/pubmed PY - 2019/10/18/medline SP - e17387 EP - e17387 JF - Medicine JO - Medicine (Baltimore) VL - 98 IS - 41 N2 - BACKGROUND: Double-lumen bronchial tubes (DLBT) and bronchial blockers (BB) are commonly used in the anesthesia for clinical thoracic surgery. But there are few systematic clinical comparisons between them. In this study, the effects of BB and DLBT on one-lung ventilation (OLV) are studied. METHODS: The 200 patients with thoracic tuberculosis undergoing thoracic surgery, were randomly assigned to group A (DLBT) and group B (BB). Intubation time, hemodynamic changes (mean arterial pressure [MAP], heart rate [HR]), and arterial blood gas indicators (arterial partial pressure of carbon dioxide [PaCO2], arterial partial pressure of oxygen [PaO2], airway plateau pressure [Pplat], and airway peak pressure [Ppeak]) at 4 time points were recorded. Complications such as hoarseness, pulmonary infection, pharyngalgia, and surgical success rate were also evaluated postoperatively. RESULTS: Intubation times were shorter in group B. Both MAP and HR in group A were significantly higher 1 minute after intubation than before, but also higher than those in group B. PaO2 levels were lower in both groups during (OLV) than immediately after anesthesia and after two-lung ventilation (TLV), with PaO2 being lower after 60 minutes of OLV than after 20 minutes of OLV. Furthermore, at both points during OLV, PaO2 was lower in group A than in group B. No significant differences in PaCO2 were found between the 2 groups. Ppeak and Pplat were increased in both groups during OLV, with both being higher in group A than in group B. The incidence of postoperative hoarseness, pulmonary infection, and pharyngalgia were lower in group B. There was no significant difference in the success rate of operation between the 2 groups. CONCLUSIONS: Compare with using DLBT, implementation of BB in general anesthesia has less impact on hemodynamics, PaO2 and airway pressures, and achieves lower incidence of postoperative complication. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/31593088/Effects_of_bronchial_blockers_on_one-lung_ventilation_in_general_anesthesia:_A_randomized_controlled_trail L2 - http://dx.doi.org/10.1097/MD.0000000000017387 DB - PRIME DP - Unbound Medicine ER -