COMPARISON OF CLINICAL EFFICACY OF RIGHT VERSUS LEFT SIDED DOUBLE LUMEN ENDOBRONCHIAL TUBE IN CONJUNCTION WITH FIBEROPTIC BRONCHOSCOPE
Efficacy Of Right Versus Left Sided Double Lumen Endobronchial Tube
Keywords:Flexible fiberotpic bronchoscope, Insertion time, Intra-operative hypoxia incidence, Oxygen insufflations, Right versus left double lumen endobronchial tube.
Objective: We compared right and left sided double lumen endobronchial tube (DLT) regarding their clinical efficacy and safety profile in when they are used in conjunction with flexible fiberoptic bronchoscope.
Study Design: Quasi experimental study.
Place and Duration of Study: Anesthesiology department, Combined Military Hospital Rawalpindi for 05 months, from Apr to Aug 2017.
Material and Methods: After the approval of the hospital ethical committee, 90 patients were included in our study. Auscultation was used to check proper position. A flexible fiberoptic bronchoscope was used to confirm auscultation finding. The insertion time; incidence of tube malposition (supine and lateral); intra-operative hypoxia and hypercapnia were recorded.
Results: A total of 90 patients underwent various thoracic surgery procedures with one lung ventilation. After the data collection, 13 patients were excluded from final analysis. Of the 77 cases, 55 patients (group L) had placement of left sided double lumen endobronchial tube; whereas 22 patients (group R) had right sided double lumen endobronchial tube. The two groups didn’t vary in their demographic profile. The insertion time was significantly longer in right DLT insertion, 296.6 ± 49.8 second versus 239 ± 33.4 second (p-value<0.001). The frequency of tube malposition was higher in right DLT, 45.4% versus 16.6% in left, p-value 0.01. However, the incidence of hypoxia, hypercapnia and tube migration (all p-value>0.05) did not vary between the two groups. One patient in right DLT versus two patients in left group required return to two lung ventilation for treatment of hypoxia, p-value 0.64.
Conclusion: Our study has shown that right sided double lumen endobronchial tubehad similar clinical efficacy as left double lumen endobronchial tube when they are used for fiberoptic bronchoscope.