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Application of Tracheal Intubation in Lateral Position in Thoracic Surgery

Not Applicable
Completed
Conditions
Tracheal Intubation
Anesthesia
Thoracic Surgery
Interventions
Other: Changes in intubation position
Registration Number
NCT05482230
Lead Sponsor
xiangming fang
Brief Summary

This study investigated the incidence of bronchial blocker malposition in the lateral versus supine position and evaluated the effectiveness of lateral placement.

Detailed Description

Routine thoracic surgery anesthesia requires that endotracheal intubation be performed with the patient in the supine position; the patient subsequently needs to be placed in a lateral position through the cooperation of the anesthetist, theatre nurse, and surgeon. Achieving this change in position is time-consuming and likely to result in adverse events, such as loss of the anesthetic airway and arteriovenous catheter, hemodynamic fluctuations, and malposition of the BB which adversely affect anesthesia management and postoperative recovery. For patients with hypertensive heart disease, the risk of cardiovascular and cerebrovascular accidents increases during the perioperative period .

Therefore, we conducted a prospective, randomized, controlled, multi-center study to evaluate the ease, efficacy, and safety of video laryngoscopy-guided intubation and bronchial blocker placement performed in lateral position.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
306
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
BB in lateral positionChanges in intubation positionThe bronchial blocker group was inserted in lateral position
DLT in lateral positionChanges in intubation positionThe double-lumen bronchial group was inserted in lateral position
Primary Outcome Measures
NameTimeMethod
The incidence of bronchial blocker malposition.During surgery

The incidence of bronchial blocker malposition in two groups S and L

Secondary Outcome Measures
NameTimeMethod
The times of bronchial blocker repositionDuring surgery

The times of bronchial blocker reposition in lateral group and supine group

The duration of intubationDuring surgery

The duration of intubation, including the time for single-lumen tube intubation, the time for bronchial blocker placement, and the total intubation time (single-lumen tube intubation plus bronchial blocker placement)

The pressure of ventilationDuring surgery

The pressure of ventilation during mask ventilation, two-lung ventilation (TLV) and one-lung ventilation(OLV)

Intubation-related complicationsDuring surgery, after the patient regained full consciousness and before discharge from the post-anesthesia care unit, on the day after surgery, and 2 weeks postoperatively.

Intubation-related complications, including airway injury, dental injury, sore throat, and hoarseness

Postural injuriesThese complications were assessed at three time points: after the patient regained full consciousness and before discharge from the post-anesthesia care unit, on the day after surgery, and 2 weeks postoperatively.

Postural injuries were defined as new-onset injuries not present before surgery but occurring within the first 2 weeks postoperatively, including neuropathies, vasculopathies, and musculoskeletal injuries

Lung collapse gradeDuring surgery

When the chest wall was opened, the lung collapse was graded as follows: fully collapsed lung, non-collapsed lung with no visible ventilation, or fully ventilated lung

Perioperative vital signsImmediately after arrival at operating room; Before single lumen tube intubation; After single lumen tube intubation ; One-lung ventilation; Before single lumen tube extubating; 5 minutes after single lumen tube extubating.

Perioperative vital signs, including mean arterial pressure (MAP), heart rate (HR), and SpO2

HypoxemiaDuring surgery

Hypoxemia was defined as a drop in oxygen saturation (SpO2) below 92%

The satisfaction scoresPerioperative period

The satisfaction scores of patients, nurses and surgeons. Satisfaction scores were used a 0-10 scale (10 = very satisfied).

Trial Locations

Locations (1)

Jie Zhao

🇨🇳

Hangzhou, Zhejiang, China

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