Blind endobronchial insertion of a movable bronchial blocker attached to an endotracheal tube, Univent tube~(TM)

摘要

The endotracheal tube with a movable bronchial blocker, Univent tube~(TM), used to effect one-lung ventilation is easy to use hi endotracheal intubation. However, problems are often encountered when inserting the blocker into the bronchus. We herein describe a method which enables the easy blind insertion of the blocker into the left or right bronchus. The techniques of inserting the blocker into the left main stem bronchus will be described. With the patient in a supine position, the head of the patient is moved to the left. The operator then places his right hand fingers near the cricoid and presses to displace the larynx of the patient toward the right. While performing this procedure, the operator advances the blocker using the left hand. Finally, using a bronchoscope, the placing of the blocker is to be ascertained in an appropriate position inside the left bronchus. When strong resistance is left, the blocker should be retracted, the force of laryngeal displacement is altered and, then, the blocker is inserted again in a resistance-free manner. We have so far experienced no complications such as severe tracheobronchial hemorrhage, tracheobronchial perforation of laryngeal dislocation. We herein describe a useful and simple method for inserting the bronchial blocker of the Univent tube into the bronchus.