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Br J Anaesth. 2004 Oct;93(4):525-7. Epub 2004 Jul 9.

Audit of double-lumen endobronchial intubation.

Author information

1
Department of Anaesthetics, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS, UK. alan.seymour@heartsol.wmids.nhs.uk

Abstract

BACKGROUND:

Many technical variations are possible in the placing and management of a double-lumen tube (DLT). We surveyed our practice to relate these variations to the course of the anaesthetic.

METHODS:

We used a questionnaire to obtain details of technique in 506 consecutive double lumen intubations. The details were related to the incidence of secretions, tube displacement, and decreases of oxygen saturation (<88%) during one lung anaesthesia (OLA).

RESULTS:

Robertshaw tubes were used for 482 of the 506 intubations. During OLA there were 48 instances of desaturation (<88%), 19 cases of upper lobe obstruction, 15 of carinal obstruction, 16 of isolation failure, eight of excessive secretions (none of whom had received an antisialogogue; P<0.01) and 12 miscellaneous events. The experience of the anaesthetist or use of a fibre-optic bronchoscope did not affect these events. Air was of no advantage as a maintenance gas. Atropine 400-600 micro g appeared to prevent desaturation on OLA (P<0.05) but glycopyrrolate 200 micro g did not.

CONCLUSION:

Most factors had little effect on the progress of the anaesthetic, but an antimuscarinic usefully reduced secretions, and atropine (but not glycopyrrolate) was associated with less desaturation during OLA.

PMID:
15247113
DOI:
10.1093/bja/aeh229
[Indexed for MEDLINE]
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