title: The uses of laryngeal mask airway ProSeal™ and endobronchial blocker for one lung anesthesia.
abstract: OBJECTIVE
  The use of an endobronchial blocker in conjunction with a supraglottic device in elective thoracic cases has never been studied. The aim of this study was to report the success rate and time to placement of the endobronchial blocker in anaesthetized patients with a laryngeal mask airway (LMA)-ProSeal™ in place.
  
  
  METHODS
  This was a single-center, prospective, descriptive pilot study that enrolled 30 patients aged 18-75 years, with ASA I-III, who underwent elective thoracotomy or video-assisted thoracoscopy. We collected data on time to placement of the endobronchial blocker into the selected bronchus, time consumed for final blocker positioning and inflation, lung deflation score at chest opening, and postoperative airway complications.
  
  
  RESULTS
  One patient was excluded because of high peak airway pressure during LMA ventilation. The time required for blocker placement in the right main bronchus was shorter [mean 160 (78-480) s] compared with that for the left main bronchus [225 (117-420) s]. The blocker was successfully placed on the first attempt in 25 patients. Lung deflation score graded by the surgeon was 8/10 (median). Minor postoperative airway complications, such as sore throat (28.6 %) and hoarseness of voice (17.9 %), were reported.
  
  
  CONCLUSIONS
  The use of LMA-ProSeal™ in conjunction with the COOPDECH Endobronchial Blocker Tube may be considered an alternative one-lung ventilation technique in selected cases. However, success rates and time required for placement of the blocker seem dependent on the operator's skill. Although postoperative sore throat and hoarseness of voice were reported, these improved in 24 h.
authors.affiliation: Mahidol University, Bangkoknoi, Bangkok, Thailand. prasert.saw@mahidol.ac.th.
authors.forename: Prasert
authors.initials: P
authors.lastname: Sawasdiwipachai
authors.affiliation: Mahidol University, Bangkoknoi, Bangkok, Thailand.
authors.forename: Settapong
authors.initials: S
authors.lastname: Boonsri
authors.affiliation: Mahidol University, Bangkoknoi, Bangkok, Thailand.
authors.forename: Sirilak
authors.initials: S
authors.lastname: Suksompong
authors.affiliation: Mahidol University, Bangkoknoi, Bangkok, Thailand.
authors.forename: Paron
authors.initials: P
authors.lastname: Prowpan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000758:Anesthesia / Q000379:methods*; D001980:Bronchi / Q000378:metabolism; D017558:Elective Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D017214:Laryngeal Masks; D008168:Lung / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D061810:One-Lung Ventilation / Q000379:methods*; D010612:Pharyngitis / Q000209:etiology; D010865:Pilot Projects; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D055815:Young Adult
keywords: Endobronchial blocker; Laryngeal mask airway; One-lung ventilation; ProSeal
references.citation: Anaesthesia. 2004 Jul;59(7):726
references.pmid: 15200557
references.citation: Anesthesiology. 1994 Mar;80(3):550-5
references.pmid: 8141451
references.citation: Masui. 2007 Sep;56(9):1075-7
references.pmid: 17877050
references.citation: Can J Anaesth. 2005 Aug-Sep;52(7):739-60
references.pmid: 16103390
references.citation: Anesthesiol Clin. 2008 Jun;26(2):241-72, v
references.pmid: 18456211
references.citation: J Cardiothorac Vasc Anesth. 2008 Dec;22(6):883-6
references.pmid: 18834756
references.citation: J Anesth. 2010 Dec;24(6):908-12
references.pmid: 20838819
references.citation: Anaesth Intensive Care. 2002 Oct;30(5):624-7
references.pmid: 12413264
references.citation: J Anaesthesiol Clin Pharmacol. 2010 Oct;26(4):451-7
references.pmid: 21547168
references.citation: Indian J Anaesth. 2013 Jul;57(4):339-44
references.pmid: 24163446
references.citation: J Cardiothorac Vasc Anesth. 1998 Apr;12(2):186-8
references.pmid: 9583552
references.citation: Anesthesiology. 2000 Jul;93(1):104-9
references.pmid: 10861152
references.citation: Ochsner J. 2013 Fall;13(3):389-93
references.pmid: 24052770
references.citation: Br J Anaesth. 2009 Dec;103(6):902-3
references.pmid: 19918029
references.citation: Can J Anaesth. 2002 Oct;49(8):857-62
references.pmid: 12374716
references.citation: Br J Anaesth. 1999 Feb;82(2):286-7
references.pmid: 10365012
references.citation: Br J Anaesth. 2000 Aug;85(2):262-6
references.pmid: 10992836
references.citation: Curr Opin Anaesthesiol. 2010 Feb;23(1):12-7
references.pmid: 19752725
references.citation: Anesth Analg. 2014 Mar;118(3):666-70
references.pmid: 24557112
references.citation: Anesth Analg. 1997 Sep;85(3):573-7
references.pmid: 9296411
references.citation: Br J Anaesth. 2006 Dec;97(6):878-82
references.pmid: 16984953
references.citation: Can J Anaesth. 2003 Jan;50(1):71-7
references.pmid: 12514155