Abstract

Background

The double-lumen tube (DLT) is an essential equipment for thoracic anesthesia and the precise position of DLT placement is particularly important for anesthesia and surgery. However, the incidence of DLT malposition remains high and it leads to lung isolation failure and hypoxemia during one-lung ventilation. This trial aims to explore the clinical application and efficacy of intubation in the lateral position under general anesthesia induction to reduce the incidence of DLT malposition in patients undergoing unilateral video-assisted thoracic surgery (VATS).

Methods

In this prospective, single-center, parallel group, randomized, controlled trial, we will recruit 108 patients, aged 18–80 years, scheduled for elective unilateral VATS with DLT intubation under general anesthesia, and they will be randomly assigned to two groups: a lateral DLT intubation group (group L) and a conventional supine DLT intubation group (group C). The left-sided DLT will be used to intubate in patients of both groups. The position of DLT will be confirmed and adjusted by using the fiberoptic bronchoscopy (FOB). The primary outcome is the incidence of DLT malposition observed via the FOB, and the secondary outcomes include the time of intubation, the frequency and duration of re-adjustments of DLT placement under FOB, whether to re-intubate, intraoperative vital signs, and postoperative recovery.

Discussion

Accurate DLT positioning is crucially important for thoracic surgery, but the incidence of DLT malposition is still high in the present clinical practice of thoracic anesthesia. This trial aims to investigate whether lateral DLT intubation can reduce the incidence of DLT malposition, with more stable intraoperative vital signs and less postoperative complications.

Trial registration

The study protocol was registered at Chinese Clinical Trial Registry (http://www.chictr.org.cn) with registration number: ChiCTR2200060794 on June 11, 2022.

Details

Title
Effect of intubation in the lateral position under general anesthesia induction on the position of double-lumen tube placement in patients undergoing unilateral video-assisted thoracic surgery: study protocol for a prospective, single-center, parallel group, randomized, controlled trial
Author
Zhang, Xi 1 ; Wang, Dong-Xu 2 ; Zhang, Qin 2 ; Shen, Qi-Bin 3 ; Tong, Fei 2 ; Hu, Yong-He 2 ; Zhang, Zhen-Duo 2 ; Liu, Fei-Fan 2 ; Tang, Ya-Wen 2 ; Chen, Juan-Li 4 ; Liu, He 2 ; Zhou, Feng 5 ; Hu, Si-Ping 2   VIAFID ORCID Logo 

1  Huzhou Central Hospital || The Affiliated Huzhou Hospital, Zhejiang University School of Medicine || Affiliated Central Hospital Huzhou University, Department of Anesthesiology & Huzhou Key Laboratory of Basic Research and Clinical Translation for Neuromodulation, Huzhou, China (GRID:grid.13402.34) (ISNI:0000 0004 1759 700X); The First Affiliated Hospital, Zhejiang University School of Medicine, Department of Anesthesiology, Hangzhou, China (GRID:grid.452661.2) (ISNI:0000 0004 1803 6319) 
2  Huzhou Central Hospital || The Affiliated Huzhou Hospital, Zhejiang University School of Medicine || Affiliated Central Hospital Huzhou University, Department of Anesthesiology & Huzhou Key Laboratory of Basic Research and Clinical Translation for Neuromodulation, Huzhou, China (GRID:grid.13402.34) (ISNI:0000 0004 1759 700X) 
3  Huzhou Central Hospital || The Affiliated Huzhou Hospital, Zhejiang University School of Medicine || Affiliated Central Hospital Huzhou University, Department of Cardiothoracic Surgery, Huzhou, China (GRID:grid.13402.34) (ISNI:0000 0004 1759 700X) 
4  Huzhou Central Hospital || The Affiliated Huzhou Hospital, Zhejiang University School of Medicine || Affiliated Central Hospital Huzhou University, Department of Operating Room Nursing, Huzhou, China (GRID:grid.13402.34) (ISNI:0000 0004 1759 700X) 
5  Huzhou Central Hospital || The Affiliated Huzhou Hospital, Zhejiang University School of Medicine || Affiliated Central Hospital Huzhou University, Medical Department, Huzhou, China (GRID:grid.13402.34) (ISNI:0000 0004 1759 700X) 
Pages
67
Publication year
2023
Publication date
Dec 2023
Publisher
Springer Nature B.V.
e-ISSN
17456215
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1186/s13063-023-07075-9
ProQuest document ID
2770548508
Copyright
© The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.