Hemodynamic and Humoral Response to Intubation with Double-lumen Endotracheal Tubes Versus Single-lumen Tubes Combined with an Endobronchial Blocker: A Randomized Clinical Trial

Nabecker, Sabine; Grubhofer, G.; Hager, Helmut; Goliasch, Georg; Fischer, Henrik; Bernardi, Martin H.; Sessler, Daniel I.; Ruetzler, Kurt

doi:10.4172/2155-6148.1000377

Cited by 3 publications

(2 citation statements)

References 26 publications

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“…DLT placement is technically more challenging and causes greater haemodynamic disturbance and trauma than single-lumen tube placement[ 3 4 ] even in patients with Cormack Lehane grade 1 view. This difficulty is compounded if the airway happens to be even a borderline difficult one (Cormack Lehane grade 2 onwards).…”

Section: Introductionmentioning

confidence: 99%

A randomized clinical trial comparing the standard mcintosh laryngoscope and the c-mac d blade video laryngoscope™ for double lumen tube insertion for one lung ventilation in Onco surgical patients

et al. 2016

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Background and Aims:Several devices enabling double-lumen tube (DLT) placement for thoracic surgeries are available, but there are no studies for D-blade video laryngoscope-guided DLT insertion. We compared the CMac D-blade videolaryngoscope™ and the Macintosh laryngoscope for DLT endobronchial intubation using parameters of time and attempts required for intubation, glottic view, incidence of complications and haemodynamic changes.Methods:Prospective, parallel group, randomised controlled clinical trial where sixty American Society of Anesthesiologists I and II patients aged 18-80 years scheduled for thoracic surgeries entailing DLT placement were randomly allocated in two groups based on the laryngoscopic device used for endobronchial intubation. Data were subjected to statistical analysis SPSS (version 17), the paired and Student's t-test for equality of means. Nominal categorical data between the groups were compared using Chi-squared test or Fisher's exact test as appropriate. P ˂ 0.05 was considered statistically significant.Results:Time required for intubation was comparable (37.41 ± 18.80 s in Group-M and 32.27 ± 11.13 s in Group-D). Number of attempts and incidence of complications (trauma, DLT cuff rupture, oesophageal intubation) was greater in the Macintosh group, except malpositioning into the wrong bronchus (easily rectified fibre-optic bronchoscopically), which was greater with the D-blade. Greater haemodynamic changes were observed during Macintosh laryngoscopy.Conclusion:D-blade videolaryngoscope™ is a useful alternative to the standard Macintosh laryngoscope for routine DLT insertion.

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Section: Introductionmentioning

confidence: 99%

A randomized clinical trial comparing the standard mcintosh laryngoscope and the c-mac d blade video laryngoscope™ for double lumen tube insertion for one lung ventilation in Onco surgical patients

et al. 2016

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“…This difficulty is compounded if it is done by an occasional thoracic anesthetist or if the patient has a difficult airway. [ 2 3 ]…”

Section: Introductionmentioning

confidence: 99%

A randomized control led study comparing CMAC video laryngoscope and Macintosh laryngoscope for insertion of double lumen tube in patients undergoing elective thoracotomy

Mathew

Chandy

Punnoose

et al. 2021

Journal of Anaesthesiology Clinical Pharmacology

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Background and Aims: Double lumen tube (DLT) insertion for isolation of lung during thoracic surgery is challenging and is associated with considerable airway trauma. The advent of video laryngoscopy has revolutionized the management of difficult airway. Use of video laryngoscopy may reduce the time to intubate for DLTs even in patients with normal airway. Material and Methods: A total of 87 ASA 1–3 adults, scheduled to undergo elective thoracotomy, requiring a DLT were randomly allocated to videolaryngoscope (CMAC) arm or Macintosh laryngoscope arm. It was on open label study, and only the patient was blinded. The primary objective of this study was to compare the mean time taken for DLT intubation with CMAC (Mac 3) and Macintosh laryngoscope blade and the secondary objectives included the hemodynamic response to intubation, the level of difficulty using the intubation difficulty scale (IDS), and complications associated with intubation. Data was analysed using the statistical software SPSS (version 18.0). Results: The time taken for intubation was not significantly different (42.8 ± 14.8 s for CMAC and 42.5 ± 11.5 s for Macintosh laryngoscope P -0.908). The CMAC video laryngoscope was associated with an improved laryngoscopy grade (Grade I in 81.8% with CMAC and in 46.5% with Macintosh), less pressure applied on the tongue, and less external laryngeal pressure required. Hemodynamic responses to intubation were similar in both groups. Conclusion: Macintosh blade is as good as CMAC (mac 3) blade to facilitate DLT intubation in adult patients with no anticipated airway difficulty, however CMAC was superior as it offers better laryngoscopic view, needed less force, and fewer external laryngeal manipulations.

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The effect-site concentration of remifentanil for blunting hemodynamic responses: comparative study in single-lumen endotracheal and double-lumen endobronchial intubation

Park

Kim

2017

Anesth Pain Med

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Background:This study undertook to compare the effect-site concentration of remifentanil for prevention of hemodynamic responses to endotracheal intubation, employing the single-lumen tracheal tube and the double-lumen bronchial tube during total intravenous anesthesia. Methods: Based on the nature of the surgery, 38 patients undergoing general anesthesia were assigned either to the singlelumen tube group or the double-lumen tube group. Anesthesia was induced by a target controlled infusion of propofol, with an effect-site concentration of 4 g/ml. Remifentanil was then administered to the first patient in each group, with an effect-site concentration of 3.5 ng/ml. Subsequent concentration of remifentanil was determined by hemodynamic responses of the previous patient to intubation, based on the up-and-down method. Results: The effect-site concentrations of remifentanil for prevention of hemodynamic responses to endotracheal intubation in 50% of patients (EC50) were 2.8 ng/ml (95% CI, 2.0-3.7 ng/ml) in

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Hemodynamic and Humoral Response to Intubation with Double-lumen Endotracheal Tubes Versus Single-lumen Tubes Combined with an Endobronchial Blocker: A Randomized Clinical Trial

Cited by 3 publications

References 26 publications

A randomized clinical trial comparing the standard mcintosh laryngoscope and the c-mac d blade video laryngoscope™ for double lumen tube insertion for one lung ventilation in Onco surgical patients

A randomized clinical trial comparing the standard mcintosh laryngoscope and the c-mac d blade video laryngoscope™ for double lumen tube insertion for one lung ventilation in Onco surgical patients

A randomized control led study comparing CMAC video laryngoscope and Macintosh laryngoscope for insertion of double lumen tube in patients undergoing elective thoracotomy

The effect-site concentration of remifentanil for blunting hemodynamic responses: comparative study in single-lumen endotracheal and double-lumen endobronchial intubation

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