[The incidence of double-lumen tubes displacement after positioning of patients during anesthesia].
BACKGROUND
Although many reports have described that unexpected displacement of double-lumen endobronchial tube (DLT) may be caused by patient positioning, however, in Taiwan the matter has not been reported, nor its incidence has been determined. The purpose of this study was to determine the incidence of DLT displacement after patient positioning.


METHODS
Eighty patients undergoing elective thoracotomy that required an anesthesia with the use of left DLT were studied. An Olympus LF-P broncho-fiberscope was used to estimate the distance between the carina and the distal end of the DLT via the tracheal lumen before and after patient positioning.


RESULTS
All DLT were confirmed to be in the correct position in eighty patients before patient positioning. After patient positioning, the DLT moved proximally 1.5 cm, 1 cm and 0.5 cm in eighteen (22.5%), sixteen (20%) and eight (10%) patients respectively. In nine patients (11.25%) DLT displacement after positioning resulted in a failure to ventilate the lungs separately and required readjustment of the DLT.


CONCLUSIONS
Our result suggests that there is a high incidence of DLT displacement during patient positioning. Whenever the patient is repositioned, we recommend that constant vigilance is necessary to guard against tube displacement. Attention should be focused on possible causative factors so that the incidence can be decreased and the safety of DLT application assured.
Cheng
K S
KS
Department of Anesthesiology, Chang Gung Memorial Hospital, Taipei, R.O.C.
Tan
P P
PP
D000758:Anesthesia; D006801:Humans; D007442:Intubation, Intratracheal; D011187:Posture