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.

Lee, Soomin; Han, Sung Joon; Park, Jiho; Kim, Yoon-Hee; Hong, Boohwi; Oh, Chahyun; Yoon, Seok-Hwa

Lee, Soomin; Han, Sung Joon; Park, Jiho; Kim, Yoon-Hee; Hong, Boohwi; Oh, Chahyun; Yoon, Seok-Hwa.

Afiliación

Lee S; Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea.
Han SJ; Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea.
Park J; Department of Thoracic and Cardiovascular Surgery, College of Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea.
Kim YH; Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea.
Hong B; Department of Anesthesiology and Pain Medicine, Sejong Chungnam National University Hospital, Sejong 30099, Republic of Korea.
Oh C; Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea.
Yoon SH; Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea.

J Clin Med ; 13(17)2024 Sep 06.

Article en En | MEDLINE | ID: mdl-39274515

ABSTRACT

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.

Palabras clave

airway management; double-lumen tube; intubation success rate; intubation time; non-rotatory technique; one-lung ventilation; thoracic surgery; video laryngoscopy

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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article Pais de publicación: Suiza