Effect of intubation in the lateral position under general anesthesia induction on the position of double-lumen tube placement in patients undergoing unilateral video-assisted thoracic surgery: study protocol for a prospective, single-center, parallel group, randomized, controlled trial

被引：3

作者：

Zhang, Xi ^{[1
,2
,3
,4
,5
]}

Wang, Dong-Xu ^{[1
,2
,3
,4
]}

Zhang, Qin ^{[1
,2
,3
,4
]}

Shen, Qi-Bin ^{[2
,3
,4
,6
]}

Tong, Fei ^{[1
,2
,3
,4
]}

Hu, Yong-He ^{[1
,2
,3
,4
]}

Zhang, Zhen-Duo ^{[1
,2
,3
,4
]}

Liu, Fei-Fan ^{[1
,2
,3
,4
]}

Tang, Ya-Wen ^{[1
,2
,3
,4
]}

Chen, Juan-Li ^{[2
,3
,4
,7
]}

Liu, He ^{[1
,2
,3
,4
]}

Zhou, Feng ^{[2
,3
,4
,8
]}

Hu, Si-Ping ^{[1
,2
,3
,4
]}

机构：

[1] Huzhou Cent Hosp, Dept Anesthesiol, 1558 Sanhuan North Rd, Huzhou 313000, Zhejiang, Peoples R China

[2] Huzhou Cent Hosp, Huzhou Key Lab Basic Res & Clin Translat Neuromodu, 1558 Sanhuan North Rd, Huzhou 313000, Zhejiang, Peoples R China

[3] Zhejiang Univ, Affiliated Huzhou Hosp, Sch Med, 1558 Sanhuan North Rd, Huzhou 313000, Zhejiang, Peoples R China

[4] Huzhou Univ, Affiliated Cent Hosp, 1558 Sanhuan North Rd, Huzhou 313000, Zhejiang, Peoples R China

[5] Zhejiang Univ, Affiliated Hosp 1, Sch Med, Dept Anesthesiol, Hangzhou, Peoples R China

[6] Huzhou Cent Hosp, Dept Cardiothorac Surg, 1558 Sanhuan North Rd, Huzhou 313000, Zhejiang, Peoples R China

[7] Huzhou Cent Hosp, Dept Operating Room Nursing, 1558 Sanhuan North Rd, Huzhou 313000, Zhejiang, Peoples R China

[8] Huzhou Cent Hosp, Med Dept, 1558 Sanhuan North Rd, Huzhou 313000, Zhejiang, Peoples R China

来源：

TRIALS | 2023年 / 24卷 / 01期

基金：

中国国家自然科学基金;

关键词：

Double-lumen tube; Intratracheal intubation; Malposition; Lateral position; Video-assisted thoracic surgery; Thoracic anesthesia; Fiberoptic bronchoscopy; LUNG ISOLATION; DISPLACEMENT; MALPOSITION; EXPERIENCE; RELOCATION;

D O I：

10.1186/s13063-023-07075-9

中图分类号：

R-3 [医学研究方法]; R3 [基础医学];

学科分类号：

1001 ;

摘要：

Background The double-lumen tube (DLT) is an essential equipment for thoracic anesthesia and the precise position of DLT placement is particularly important for anesthesia and surgery. However, the incidence of DLT malposition remains high and it leads to lung isolation failure and hypoxemia during one-lung ventilation. This trial aims to explore the clinical application and efficacy of intubation in the lateral position under general anesthesia induction to reduce the incidence of DLT malposition in patients undergoing unilateral video-assisted thoracic surgery (VATS).Methods In this prospective, single-center, parallel group, randomized, controlled trial, we will recruit 108 patients, aged 18-80 years, scheduled for elective unilateral VATS with DLT intubation under general anesthesia, and they will be randomly assigned to two groups: a lateral DLT intubation group (group L) and a conventional supine DLT intubation group (group C). The left-sided DLT will be used to intubate in patients of both groups. The position of DLT will be confirmed and adjusted by using the fiberoptic bronchoscopy (FOB). The primary outcome is the incidence of DLT malposition observed via the FOB, and the secondary outcomes include the time of intubation, the frequency and duration of re-adjustments of DLT placement under FOB, whether to re-intubate, intraoperative vital signs, and postoperative recovery.Discussion Accurate DLT positioning is crucially important for thoracic surgery, but the incidence of DLT malposition is still high in the present clinical practice of thoracic anesthesia. This trial aims to investigate whether lateral DLT intubation can reduce the incidence of DLT malposition, with more stable intraoperative vital signs and less postoperative complications.

引用

页数：10

共 22 条

[1]

Ajimi Junko, 2021, Tokai J Exp Clin Med, V46, P22

[2]

Benumof J L, 1993, J Cardiothorac Vasc Anesth, V7, P513, DOI 10.1016/1053-0770(93)90303-3

[3] Left double-lumen tubes: Clinical experience with 1,170 patients [J].

Brodsky, JB ;

Lemmens, HJM .

JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2003, 17 (03) :289-298

[4] MALPOSITION OF LEFT-SIDED DOUBLE-LUMEN ENDOBRONCHIAL TUBES [J].

BRODSKY, JB ;

SHULMAN, MS ;

MARK, JBD .

ANESTHESIOLOGY, 1985, 62 (05) :667-669

[5] Devices for lung isolation used by anesthesiologists with limited thoracic experience -: Comparison of double-lumen endotracheal tube, Univent® torque control blocker, and Arndt wire-guided endobronchial Blocker® [J].

Campos, JH ;

Hallam, EA ;

Van Natta, T ;

Kernstine, KH .

ANESTHESIOLOGY, 2006, 104 (02) :261-266

[6]

Cohen Edmond, 2004, Curr Opin Anaesthesiol, V17, P1, DOI 10.1097/00001503-200402000-00002

[7] The effects of endobronchial cuff inflation on double-lumen endobronchial tube movement after lateral decubitus positioning [J].

Desiderio, DP ;

Burt, M ;

Kolker, AC ;

Fischer, ME ;

Reinsel, R ;

Wilson, RS .

JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 1997, 11 (05) :595-598

[8] Lung Isolation for Thoracic Surgery: From Inception to Evidence-Based [J].

Falzon, David ;

Alston, R. Peter ;

Coley, Emma ;

Montgomery, Katriona .

JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2017, 31 (02) :678-693

[9]

Hurford W E, 1993, J Cardiothorac Vasc Anesth, V7, P517, DOI 10.1016/1053-0770(93)90305-5

[10] Double lumen tube location predicts tube malposition and hypoxaemia during one lung ventilation [J].

Inoue, S ;

Nishimine, N ;

Kitaguchi, K ;

Furuya, H ;

Taniguchi, S .

BRITISH JOURNAL OF ANAESTHESIA, 2004, 92 (02) :195-201

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