Trachway® flexible stylet facilitates the correct placement of double-lumen endobronchial tube: a prospective, randomized study

Hung-Te Hsu, Yi-Wei Kuo, Chao-Wei Ma, Miao-Pei Su, Kuang-Yi Tseng, Chin-Ling Li, Kuang-I Cheng, Hung-Te Hsu, Yi-Wei Kuo, Chao-Wei Ma, Miao-Pei Su, Kuang-Yi Tseng, Chin-Ling Li, Kuang-I Cheng

Abstract

Background: The mainstream facilitation of one-lung ventilation is using double-lumen endobronchial tubes. However, it is more difficult to be positioned properly and more likely to cause airway injuries. How to place double-lumen endobronchial tubes rapidly and correctly is important for thoracic anesthesiologists.

Methods: One hundred eight patients with an American Society of Anesthesiologists physical status of I to III were 20 years of age or over, and required one-lung ventilation for thoracic surgery. They were randomly assigned to the conventional technique group (n = 36), the flexible fiberoptic bronchoscopy group (n = 36), or the Trachway® flexible stylet group (n = 36). The primary endpoint was the time needed for intubation. T1, the time from the tip of the blade passing between the patient's lips to identification of the vocal cords; and T2, the time from identification of the vocal cords to the bronchial lumen was in the correct position.

Results: T1 had no significant difference between groups, but T2 was significantly shorter in the Trachway® flexible stylet group (p < 0.0001) and longer in the conventional technique group (p < 0.0001).

Conclusions: Using Trachway® flexible stylet for correct placement of double-lumen endobronchial tubes not only significantly shortened the intubation time, but also reduced incidence of carinal injuries. It is an alternative, and a choice with good safety.

Trial registration: ClinicalTrials.gov Identifier: NCT02364622, 18/02/2015, Retrospectively registered.

Keywords: Double-lumen endobronchial tubes; Mucosal complication of tracheal carina; Thoracic surgery; Trachway flexible stylet.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
The Trachway® flexible stylet
Fig. 2
Fig. 2
The pre-curved left-sided DLT
Fig. 3
Fig. 3
Five sub-regions of tracheal carina. A the entrance of right main bronchus. B the entrance of left main bronchus. C the left main bronchus. D the main carina. E the right main bronchus
Fig. 4
Fig. 4
Flow Diagram of Trachway® flexible stylet facilitates the accurate placement of double-lumen endobronchial tube

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