Comparison of a Silicon Double-Lumen Endobronchial Tube (Silbroncho(R)) with a Polyvinyl Chloride Tube (Broncho-Cath(R)) in Right-Side Thoracic Surgery

Lee, Jun Seog; Kil, Tae Young; Chung, Jin Yong

Abstract

BACKGROUND: Double-lumen endobronchial tube (DLT) malposition and displacement can occur easily by blind intubation or moving a patient into the lateral position. We compared a silicon DLT (Silbroncho(R)) with a polyvinyl chloride tube (Broncho-Cath(R)) to determine whether Silbroncho(R) can reduce the incidence of DLT malposition and displacement during anesthesia for one lung ventilation in right-side thoracic surgery.
METHODS
Thirty nine patients requiring right lung deflation were randomly assigned to one of two groups. Eighteen patients received a Broncho-Cath(R) DLT and 21 patients received a Silbroncho(R) in the left mainstem bronchus. After blind intubation, we checked the incidence of right DLT intubation and tracheobronchial injury by fiberoptic bronchoscopy (FOB). After correcting DLTs for exact position and moving patients into the lateral position, we assessed the incidence of DLT displacement and changes of peak inspiratory pressure according to this position change during one lung ventilation.
RESULTS
The incidence of right DLT intubation and tracheobronchial injury were not significantly different (P > 0.05) in the two groups (16.7% vs 0%, 38.9% vs 14.3%, Broncho-Cath(R) vs Silbroncho(R), respectively). After position change, the incidence of DLT displacement in the Silbroncho(R) group (4.8%) was lower (P < 0.05) than in the Broncho-Cath(R) group (44.8%). No significant difference was found between the two groups in terms of peak inspiratory pressure (P > 0.05).
CONCLUSIONS
Our results suggest that Silbroncho(R) can reduce the incidence of DLT displacement because of the small-sized bronchial cuff, which is located more distally than the Broncho-Cath(R) cuff. We conclude that Silbroncho(R) is superior to Broncho- Cath(R) for one lung ventilation during thoracic surgery.