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A simple blind placement of the left-sided double-lumen tubes

机译:左侧双腔管的简单盲点放置

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One-lung ventilation (OLV) has been commonly provided by using a double-lumen tube (DLT). Previous reports have indicated the high incidence of inappropriate DLT positioning in conventional maneuvers. After obtaining approval from the medical ethics committee of First Affiliated Hospital of Anhui Medical University and written consent from patients, 88 adult patients belonging to American society of anesthesiologists (ASA) physical status grade I or II, and undergoing elective thoracic surgery requiring a left-side DLT for OLV were enrolled in this prospective, single-blind, randomized controlled study. Patients were randomly allocated to 1 of 2 groups: simple maneuver group or conventional maneuver group. The simple maneuver is a method that relies on partially inflating the bronchial balloon and recreating the effect of a carinal hook on the DLTs to give an idea of orientation and depth. After the induction of anesthesia the patients were intubated with a left-sided Robertshaw DLT using one of the 2 intubation techniques. After intubation of each DLT, an anesthesiologist used flexible bronchoscopy to evaluate the patient while the patient lay in a supine position. The number of optimal position and the time required to place DLT in correct position were recorded. Time for the intubation of DLT took 100?±?16.2?seconds (mean?±?SD) in simple maneuver group and 95.1?±?20.8?seconds in conventional maneuver group. The difference was not statistically significant (P?=?0.221). Time for fiberoptic bronchoscope (FOB) took 22?±?4.8?seconds in simple maneuver group and was statistically faster than that in conventional maneuver group (43.6?±?23.7?seconds, P?P? This simple maneuver is more rapid and more accurate to position left-sided DLTs, it may be substituted for FOB during positioning of a left-sided DLT in condition that FOB is unavailable or inapplicable.
机译:通常通过使用双腔管(DLT)提供单肺通气(OLV)。先前的报道表明,常规机动中不当DLT定位的发生率很高。在获得安徽医科大学附属第一医院医学伦理委员会的批准并获得患者的书面同意后,属于美国麻醉医师协会(ASA)身体状况I级或II级的88名成年患者,并接受了需要左这项前瞻性,单盲,随机对照研究纳入了OLV的DLT侧。将患者随机分为2组中的1组:简单操作组或常规操作组。简单的操作方法是依靠部分使支气管球囊膨胀并在DLT上重新产生角叉钩的效果来给出方向和深度的方法。麻醉诱导后,使用两种插管技术之一,用左侧的Robertshaw DLT对患者进行插管。在每个DLT插管后,麻醉师使用柔性支气管镜对患者进行仰卧位评估。记录最佳位置的数量和将DLT放置在正确位置所需的时间。 DLT的插管时间在简单操作组中为100?±16.2?秒(平均?±?SD),在常规操作组中为95.1?±?20.8?秒。差异无统计学意义(P≤0.221)。简单操作组中的纤维支气管镜(FOB)时间花费了22?±?4.8?秒,并且在统计学上比常规操作组中的时间要短(43.6?±?23.7?s,P?P?)。如果要精确定位左侧DLT,则在FOB不可用或不适用的情况下,可以在定位左侧DLT期间用FOB代替。

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