Airway injuries after one-lung ventilation: a comparison between double-lumen tube and endobronchial blocker: a randomized, prospective, controlled trial.
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.
Knoll
Heike
H
Department of Anesthesiology and Critical Care Medicine, University Hospital of the Saarland, Germany.
Ziegeler
Stephan
S
Schreiber
Jan-Uwe
JU
Buchinger
Heiko
H
Bialas
Patric
P
Semyonov
Kirill
K
Graeter
Thomas
T
Mencke
Thomas
T
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*