Anesthetic Technique, One-lung Ventilation
Conditions
Keywords
LMA, Bronchial blocker
Brief summary
An observational pilot study to determine the success rate of using LMA Proseal in conjuction with endobronchial blocker to provide one-lung anesthesia for thoracic surgery.
Detailed description
The use of LMA has gained popularity secondary to benefits confirmed by many literatures. However, LMA is rarely used in thoracic surgery. To enable one-lung ventilation, the LMA need to be used with bronchial blocker. The use of this combination has been reported as a rescue technique in special clinical scenarios, i.e. patient with difficult airway. When used in patient with difficult airway, the LMA will be inserted until proper ventilation achieved, then endobronchial blocker will be subsequently placed through the LMA into the selected main bronchus. The success rate of the the bronchial blocker placement via properly placed LMA has never been studied. This pilot study was designed to evaluate the success rate, the quality of lung collapsed, the dislodgement or other associated problems including some minor complications i.e. postoperative dysphagia, sore throat hoarseness of voice.
Interventions
DEVICEBronchial blocker (Coopdech, Arndt)
Using bronchial blocker with LMA
DEVICELMA-ProsealTM
Sponsors
Mahidol University
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* thoracic surgery that needed one-lung ventilation
Exclusion criteria
patient with * Restrictive lung disease that needed positive pressure ventilation \> 30 cm.H2O * Mass or hematoma in the mouth which obstruct LMA insertion * Emergency surgery * Pregnancy * Severe infection or active pulmaonary tuberculosis * Hemoptysis * Pulmonary nodule \> 20 cm. or bronchilal pathology * Pneumonectomy or sleeve resection
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| success rate | 15 mintues | can provide one-lung ventilation within 15 mintues |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time consuming in achieving one-lung anesthesia | 15 mintues | Total time spent to place bronchial blocker into the selected main bronchus shall not exceed 15 minutes. If investigators failed, the study will be terminated and patient will receive appropriate conventional airway management. |
| Sorethroat | 1 day | Patient self assessment scale as followed 0 - no sore throat 1. \- mild sore throat (no pain at rest, only with swallowing, does not require intervention) 2. \- moderate sore throat (some discomfort at rest, more with swallowing - but does not need medications) 3. \- severe sore throat (at rest, require analgesics for sore throat) |
| Hoarseness of voice | 1 day | Patient assessment scale by visitor as followed 0 - no hoarseness of voice detected, normal voice. 1. \- some hoarseness of voice detected but able to speak in all octaves. 2. \- notable hoarseness of voice, unable to phonate in high pitch. 3. \- marked hoarseness of voice, unable to phonate |
| Difficulty swallowing | 1 day | Patient self assessment and visitor assessment in scale as followed. 0 - no problem swallowing. no pain. 1. \- some sore throat (grade 1) with swallowing but able to swallowing both liquid and solid. 2. \- moderate swallowing limitation, only liquid or soft diet swallowing - unable to swallow solid food 3. \- marked swallowing limitation, patient prefers to fast due to pain associated with swallowing. Speech therapist/OT/PT consult to evaluation swallowing problems |
Countries
Thailand
Outcome results
None listed