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

Trials

Study Protocol

Dong-Xu Wang¹  Yong-He Hu¹  He Liu¹  Si-Ping Hu¹  Fei-Fan Liu¹  Fei Tong¹  Ya-Wen Tang¹  Zhen-Duo Zhang¹  Qin Zhang¹  Xi Zhang²  Qi-Bin Shen³  Juan-Li Chen⁴  Feng Zhou⁵ 

[1] Department of Anesthesiology & Huzhou Key Laboratory of Basic Research and Clinical Translation for Neuromodulation, Huzhou Central Hospital

[2] 

[3]  The Affiliated Huzhou Hospital, Zhejiang University School of Medicine

[4]  Affiliated Central Hospital Huzhou University, No. 1558 Sanhuan North Road, Wuxing District, 313000, Huzhou, Zhejiang Province, China;Department of Anesthesiology & Huzhou Key Laboratory of Basic Research and Clinical Translation for Neuromodulation, Huzhou Central Hospital

[5]  Affiliated Central Hospital Huzhou University, No. 1558 Sanhuan North Road, Wuxing District, 313000, Huzhou, Zhejiang Province, China;Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China;Department of Cardiothoracic Surgery, Huzhou Central Hospital

[6]  Affiliated Central Hospital Huzhou University, No. 1558 Sanhuan North Road, Wuxing District, 313000, Huzhou, Zhejiang Province, China;Department of Operating Room Nursing, Huzhou Central Hospital

[7]  Affiliated Central Hospital Huzhou University, No. 1558 Sanhuan North Road, Wuxing District, 313000, Huzhou, Zhejiang Province, China;Medical Department, Huzhou Central Hospital

[8]  Affiliated Central Hospital Huzhou University, No. 1558 Sanhuan North Road, Wuxing District, 313000, Huzhou, Zhejiang Province, China;

关键词: Double-lumen tube;    Intratracheal intubation;    Malposition;    Lateral position;    Video-assisted thoracic surgery;    Thoracic anesthesia;    Fiberoptic bronchoscopy;   

DOI  :  10.1186/s13063-023-07075-9

 received in 2022-08-29, accepted in 2023-01-05,  发布年份 2023

来源: Springer

【 摘 要 】

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

【 授权许可】

CC BY   
© The Author(s) 2023

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