Use of the bronchial blocker via laryngeal mask airway for one-lung
ventilation in children undergoing thoracoscopic surgery: a randomized
controlled study.
Abstract
Aim Tracheal tubes were placed together with bronchial blocker into
trachea, which would result in increased airway resistance and
hypoventilation in young children. The aim of this study is to
investigate the efficacy and safety of laryngeal mask way (LMA) with the
bronchial blocker for OLV in children undergoing thoracoscopic surgery.
Methods: Sixty children undergoing thoracoscopic surgery were randomly
divided into two groups in this prospective, controlled clinical study.
The group A received OLV using the bronchial blocker via LMA, while the
group B received OLV using the extraluminal technique of the bronchial
blocker. The placement time of LMA and the bronchial blocker was noted.
Respiratory mechanic parameters [tidal volume (Vt), compliance of lung
(CL) and PETCO2] were recorded. Postoperative complications were also
recorded. Results: The placement time was shorter in group A than in the
group B (3.9 ± 0.5 vs. 5.2± 0.7 min, P <0.01). Vt and CL 30
min after the initiation of OLV were increased in group A than in group
B (97.3±7.4 vs 89.9±7.8 ml, 23.2±2.6 vs 20.3±3.5 ml/cmH2O, P <
0.01, respectively), while PETCO2 in group A were lower compared to the
group B (39.4±4.3 vs. 43.5±4.8 mmHg, P = 0.01). At 30 min after the
initiation of OLV, PaO2 was higher in group A (236.6±41.0 vs 208.2±45.9
mmHg, P =0.014), while PaCO2 were lower in group A (43.8± 2.5 vs 46.3±
4.1 mmHg, P = 0.006), there were statistical significant differences in
PaO2 and PaCO2 between the 2 groups. Conclusions: Use of the bronchial
blocker via LMA for OLV takes less placement time and improves
ventilation and with fewer complications compared to the extraluminal
technique. It provides a novel approach to lung isolation in pediatric
thoracic anesthesia.