[Comparison of the double-lumen endotracheal tube and the Arndt bronchial blocker used by inexperienced anesthesiologists in right- and left-sided thoracic surgery].

OBJECTIVES

To compare the effectiveness, quality of lung collapse and time anesthesiology residents required for selective intubation using the double-lumen endotracheal tube (DLT) and the Arndt bronchial blocker (ABB).

PATIENTS AND

METHODS

Patients were sequentially assigned to 2 groups according to the side of surgery and then to 2 additional subgroups according to the device used. For right-sided surgery an ABB was placed in the right main bronchus or a DLT was placed in the left bronchus; for left-sided surgery an ABB was inserted into the left bronchus or a DLT was placed on the right. DLTs were introduced into the glottis by direct laryngoscopy and then guided into the bronchus using a fiberoptic bronchoscope. ABBs were introduced according to the manufacturer's recommendations. All devices were placed in position by residents. The variables recorded were time to insert the device, number of malpositions, and quality of lung collapse.

RESULTS

Forty patients were included. Mean (SD) times for positioning each device were 4.12 (0.97) minutes for the ABB and 4.1 (2.7) minutes for the DLT in right-sided surgery and 7.92 (43) minutes for the ABB and 3.7 (1.8) minutes for the DLT in left-sided surgery (P < .015) for left sided surgery. There were no significant differences in the number of malpositionings. The quality of lung collapse was excellent in 90% of the cases.

CONCLUSIONS

In the hands of supervised, inexperienced anesthesiologists the ABB took longer to position for left-sided thoracic surgery.