PDF(Pubmed)
Abstract：
UNASSIGNED: Approximately one-third of patients who undergo double-lumen tube (DLT) intubation in the conventional supine position experience DLT malposition. No randomized study investigates the effect of DLT intubation in the lateral position. We therefore aimed to evaluate the effect of intubation in lateral position on placement of a DLT compared to supine intubation, and to test primary hypothesis that lateral DLT intubation could reduce the incidence of DLT malposition.
UNASSIGNED: We randomly allocated 108 patients undergoing video-assisted thoracic surgery to receive DLT intubation in the comfortable and surgically required lateral position (lateral group) or in the supine position (supine group) from October to December 2022. The primary outcome was the incidence of DLT malposition defined as movement >1.0 cm to correct the DLT position. The secondary outcomes included intubation time, the frequency and duration of fibreoptic bronchoscopy, the need for re-intubation, intra-operative vital signs, and post-operative recovery. This trial is registered with the Chinese Clinical Trial Registry (ChiCTR2200060794).
UNASSIGNED: The incidence of DLT malposition was significantly lower in the lateral group (1/53 [2%]) than that in the supine group (16/53 [30%]; RR [95% confidence interval] of 0.06 [0.01-0.46]; P < 0.001). Lateral DLT intubation decreased the intubation time, the frequency and duration of fibreoptic bronchoscopy. The incidence of hypotension, post-operative sore throat, and upper-arm discomfort was lower in the lateral group. Other secondary outcomes were similar between groups.
UNASSIGNED: Lateral DLT intubation reduced the incidence of DLT malposition for patients undergoing video-assisted thoracic surgery. These results support that lateral DLT intubation offers more benefits and may be a superior option compared to conventional supine intubation.
UNASSIGNED: National Natural Science Foundation of China and of Zhejiang Province.
UNASSIGNED: We randomly allocated 108 patients undergoing video-assisted thoracic surgery to receive DLT intubation in the comfortable and surgically required lateral position (lateral group) or in the supine position (supine group) from October to December 2022. The primary outcome was the incidence of DLT malposition defined as movement >1.0 cm to correct the DLT position. The secondary outcomes included intubation time, the frequency and duration of fibreoptic bronchoscopy, the need for re-intubation, intra-operative vital signs, and post-operative recovery. This trial is registered with the Chinese Clinical Trial Registry (ChiCTR2200060794).
UNASSIGNED: The incidence of DLT malposition was significantly lower in the lateral group (1/53 [2%]) than that in the supine group (16/53 [30%]; RR [95% confidence interval] of 0.06 [0.01-0.46]; P < 0.001). Lateral DLT intubation decreased the intubation time, the frequency and duration of fibreoptic bronchoscopy. The incidence of hypotension, post-operative sore throat, and upper-arm discomfort was lower in the lateral group. Other secondary outcomes were similar between groups.
UNASSIGNED: Lateral DLT intubation reduced the incidence of DLT malposition for patients undergoing video-assisted thoracic surgery. These results support that lateral DLT intubation offers more benefits and may be a superior option compared to conventional supine intubation.
UNASSIGNED: National Natural Science Foundation of China and of Zhejiang Province.
摘要：
■在常规仰卧位进行双腔管（DLT）插管的患者中约有三分之一经历DLT错位。没有随机研究调查侧卧位DLT插管的效果。因此，与仰卧位插管相比，我们旨在评估侧卧位插管对DLT放置的影响，并检验侧方DLT插管可降低DLT错位发生率的初步假设。
■从2022年10月至12月，我们随机分配了108例接受电视胸腔镜手术的患者，以舒适且手术需要的侧卧位（侧卧位）或仰卧位（仰卧位）接受DLT插管。主要结果是DLT错位的发生率，定义为移动>1.0cm以纠正DLT位置。次要结果包括插管时间，纤维支气管镜检查的频率和持续时间，需要重新插管，术中生命体征,和术后恢复。本试验在中国临床试验注册中心(ChiCTR2200060794)注册。
■侧卧组DLT错位发生率(1/53[2%])明显低于仰卧组(16/53[30%];RR[95%置信区间]0.06[0.01-0.46];P<0.001)。侧位DLT插管缩短了插管时间,纤维支气管镜检查的频率和持续时间。低血压的发生率，术后喉咙痛,外侧组上臂不适感较低。其他次要结果在组间相似。
■侧向DLT插管降低了接受电视胸腔镜手术患者DLT错位的发生率。这些结果支持横向DLT插管提供了更多的好处，并且与传统的仰卧位插管相比可能是更好的选择。
■国家自然科学基金和浙江省.
■从2022年10月至12月，我们随机分配了108例接受电视胸腔镜手术的患者，以舒适且手术需要的侧卧位（侧卧位）或仰卧位（仰卧位）接受DLT插管。主要结果是DLT错位的发生率，定义为移动>1.0cm以纠正DLT位置。次要结果包括插管时间，纤维支气管镜检查的频率和持续时间，需要重新插管，术中生命体征,和术后恢复。本试验在中国临床试验注册中心(ChiCTR2200060794)注册。
■侧卧组DLT错位发生率(1/53[2%])明显低于仰卧组(16/53[30%];RR[95%置信区间]0.06[0.01-0.46];P<0.001)。侧位DLT插管缩短了插管时间,纤维支气管镜检查的频率和持续时间。低血压的发生率，术后喉咙痛,外侧组上臂不适感较低。其他次要结果在组间相似。
■侧向DLT插管降低了接受电视胸腔镜手术患者DLT错位的发生率。这些结果支持横向DLT插管提供了更多的好处，并且与传统的仰卧位插管相比可能是更好的选择。
■国家自然科学基金和浙江省.
