Airway Injuries after One-lung Ventilation: A Comparison between Double-lumen Tube and Endobronchial Blocker

作者：H. Knoll, Stephan Ziegeler, Jan‐Uwe Schreiber, Heiko Buchinger, Patric Bialas, Kirill Semyonov, Thomas P Graeter, Thomas Mencke · 发表于：Anesthesiology · 年份：2006 · DOI：10.1097/00000542-200609000-00009 · 被引用次数：274 · 研究领域：Airway Management and Intubation Techniques、Nosocomial Infections in ICU、Tracheal and airway disorders

BACKGROUND: Vocal cord injuries, postoperative hoarseness, and sore throat are common complications after general anesthesia. One-lung ventilation can be achieved via two techniques: double-lumen endotracheal tube or endobronchial blocker such as the Arndt blocker. The current study was designed to assess the impact of these techniques for one-lung ventilation on the incidence and severity of postoperative hoarseness, vocal cord lesions, and sore throat. METHODS: In this prospective trial, 60 patients were randomly assigned to two groups. One-lung ventilation was achieved with either an endobronchial blocker (blocker group) or a double-lumen-tube (double-lumen group). Postoperative hoarseness and sore throat were assessed at 24, 48, and 72 h after surgery. Bronchial injuries and vocal cord lesions were examined by bronchoscopy immediately after surgery. RESULTS: In 56 included patients, postoperative hoarseness occurred significantly more frequently in the double-lumen group compared with the blocker group: 44% versus 17%, respectively (P = 0.046). Similar findings were observed for vocal cord lesions: 44% versus 17%, respectively (P = 0.046). The incidence of bronchial injuries was comparable between groups (P = 0.540). Cumulative number of days with hoarseness and sore throat were significantly increased in the double-lumen group compared with the blocker group (P < 0.01). No major complications such as bronchial ruptures were observed. CONCLUSIONS: Clinicians should be awa...