Cujiño-Álvarez IF, Velásquez-Galvis M

Language: Spanish
References: 9
Page: 25-30
PDF size: 482.18 Kb.

ABSTRACT

With increasing frequency the anaesthesiologist is asked to be expert in the handling of several devices for lung isolation during anaesthesia for thoracic surgery. The most used device is the double-lumen tube and although the anaesthesiologists have developed the skills necessary for placement of the tube without the need of the bronchoscope, frequently there are problems during the surgery. We decided to evaluate a different technique consisting in intubation with a single-lumen tube observing for variables like intubation time, number of attempts of intubation and complications during surgery. Twenty patients were evaluated and in 85% of them the intubation was achieved in the first attempt and the remaining 15% was achieved in the second attempt with an average time of intubation of 82.5 seconds. The lung isolation was accomplished in the 100% of the patients and only in one patient problems during the surgery were suffered. We found that the single-lumen tube is an inexpensive device which added to a simple technique may become in a quick and easy learning tool to achieve lung isolation in thoracic surgery.

REFERENCES

1. Wilkins E, Urschel H. General thoracic surgery: History and development. En: Pearson G, Cooper J, Deslauriers J, Ginsberg R, Hiebert C, Patterson A, Urschel H. Thoracic surgery. Churchill-Livingstone, second edition 2002. Página 1.

2. Ovassapian A. Conduct of Anesthesia. En: Shields T, LoCicero J, Ponn R, Rush V. General thoracic surgery. Lippincott Williams and Wilkins, 6th edition 2005: 367.

3. Campos J, Hallam E, Van Natta, Kernstine K. Devices for lung isolation used by anesthesiologists with limited thoracic experience: comparison of double-lumen endotracheal tube, Univent torque control blocker, and Arndt wire-guided endobronchial blocker. Anesthesiology 2006; 104: 261.

4. Campos J. Which device should be considered the best for lung isolation: double-lumen endotracheal tube versus bronchial blockers. Curr Opin Anaesthesiol 2007; 20: 27.

5. Wilson W, Benumof J. Anestesia en cirugía torácica. En: Miller R. Miller Anestesia. Elsevier, sexta edición, Madrid 2005: 1847.

6. Smith G, Hirsch N, Ehrenwerth J. Placement of double-lumen endobronchial tube. Correlation between clinical impressions and bronchoscopic findings. Br J Anaesth 1987; 58: 1317.

7. Molins L, Fibla J, Perez J, Sierra A, Vidal G, Simon C. Outpatient thoracic surgery programme in 300 patients: clinical results and economic impact. Eur J Cardiothorac Surg 2006; 29: 271-275.

8. Cohen E. Methods of lung separation. Curr Opin Anaesthesiol 2002; 15: 69-78.

9. Lumb A. Respiratory system resistance. En: Lumb A. Nunn´s Applied Respiratory Physiology. Butterworth and Heinemann, fifth edition, Boston 2000: 58.