title: Airway injuries after one-lung ventilation: a comparison between double-lumen tube and endobronchial blocker: a randomized, prospective, controlled trial.
abstract: 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 aware of an increased incidence of minor airway injuries that may impair patient satisfaction when using a double-lumen tube instead of an endobronchial blocker for one-lung ventilation.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, University Hospital of the Saarland, Germany.
authors.forename: Heike
authors.initials: H
authors.lastname: Knoll
authors.forename: Stephan
authors.initials: S
authors.lastname: Ziegeler
authors.forename: Jan-Uwe
authors.initials: JU
authors.lastname: Schreiber
authors.forename: Heiko
authors.initials: H
authors.lastname: Buchinger
authors.forename: Patric
authors.initials: P
authors.lastname: Bialas
authors.forename: Kirill
authors.initials: K
authors.lastname: Semyonov
authors.forename: Thomas
authors.initials: T
authors.lastname: Graeter
authors.forename: Thomas
authors.initials: T
authors.lastname: Mencke
mesh_terms: D000328:Adult; D000368:Aged; D001980:Bronchi / Q000293:injuries*; D001999:Bronchoscopy; D005260:Female; D006685:Hoarseness / Q000209:etiology*; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D010612:Pharyngitis / Q000209:etiology*; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000009:adverse effects*; D014827:Vocal Cords / Q000293:injuries*