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Korean J Anesthesiol. 2019 Feb;72(1):32-38. doi: 10.4097/kja.d.18.00012. Epub 2018 Jun 20.

Comparison of displacement of polyvinyl chloride and silicone leftsided double-lumen tubes during lateral positioning.

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1
Department of Anesthesiology and Pain Medicine, Yeungnam University School of Medicine, Daegu, Korea.

Abstract

BACKGROUND:

Compared to an equivalent sized polyvinyl chloride (PVC) double-lumen tube (DLT), a silicone DLT has a shorter endobronchial segment. The aim of this study was to compare the incidence of clinically significant displacement of left-sided PVC and silicone DLTs after a positional change to a lateral position from a supine position and determine its effect on the need for DLT repositioning for successful lung separation in patients undergoing thoracic surgery.

METHODS:

One hundred eight adult patients requiring one-lung ventilation were randomly divided into group P (PVC DLT, n = 54) and group S (Silicone DLT, n = 54). The position of the DLT was observed before and after lateral positioning to assess the effect of the position change. The incidence of clinically significant displacement (> 10 mm) of DLT was compared between the groups.

RESULTS:

DLTs were clinically significantly displaced in group P (17/48, 35.4%) and group S (18/52, 34.6%) after lateral positioning (P = 0.933). A proximal displacement (31.3% [group P] and 25.0% [group S]) was more common than distal displacement (4.2% [group P] and 9.6% [group S]), with no significant intergroup difference (P = 0.494). After lateral positioning, critical malposition of DLT with bronchial herniation to the right main bronchus was 8.3% (group P) and 7.9% (group S, P = 0.906).

CONCLUSIONS:

Left-sided PVC and silicone DLTs produced comparable incidences of clinically significant displacement and, consequently, required similar rates of repositioning for successful lung separation after lateral positioning.

KEYWORDS:

Bronchoscopy; Displacement; Intratracheal intubation; One-lung ventilation; Posture; Thoracic surgical procedure

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