The Observation Of The Application Of Viva Sight? Single-lumen Tube Plus Bronchial Blocker In Patients Undergoing Video-assisted Thoracic Surgery(VATS)

Objective:To observe the application of Viva Sight? single-lumen tube combined with bronchial blocker(BB)in one-lung ventilation lung surgery,and to guide clinical work.Methods:Patients(n=130)who underwent elective lung surgery in our hospital from 1 May 2019 to 31 December 2019 were selected to experience one-lung ventilation with bronchial occlusion technique in the period of the operation.All of the patients were randomized into control group(group C,traditional single-lumen tracheal tube plus bronchial blocker,n=59)and experimental group(group E,visual single-lumen tracheal tube plus bronchial blocker,n=71).Record the patient's gender,age,height,weight and other general conditions.Record the mean arterial pressure(MAP)and heart rate(HR)at different timepoints(T0: entering into the operation room;T1: before intubation;T2: after intubation),record the dose of induction anesthetic,the intubation time,the patient's Cormack-Lehane grade,the time of inserting bronchial blocker into right site at horizontal and the time of verification or adjustment at lateral position,the number of fiberoptic bronchoscopes used during the operation,and the displacement times of blocker.Record the usability of the tracheal tube,sore throat,hoarseness,and irritating cough.Results:1.General condition of the patients: there was no significant difference in gender,age,height,and weight between the two groups(P> 0.05).2.There was no significant difference in the MAP and HR at T0 and T1 between the two groups of patients(P> 0.05);while there was a statistically significant difference of MAP and HR at T2 which MAP and HR in the group E were higher than those in the group C(P< 0.01);There were no statistical differences in the dose of induction anesthetics(P> 0.05);There were statistically significant difference in the intubation time,the time of inserting bronchial blocker into right site at horizontal and the time of verification or adjustment at lateral position,the number of fiberoptic bronchoscopes used during the operation(P< 0.001).The intubation time of the group E was longer than that of the group C,the time of inserting bronchial blocker into right site at horizontal and the time of verification or adjustment at lateral position were shorter than those of the group C,and the number of intraoperative bronchoscopy using was less than that of the group C;There was no statistical difference in the displacement rate between the two groups of occluders(P> 0.05).There were no statistical difference in the Cormack-Lehane grade,sore throat,hoarseness and irritable cough between the two groups(P> 0.05).It was more difficult for inserting visual tube in the group E than that in the group C(P < 0.001).Conclusion:The Viva Sight? single-lumen tube combined with the BB can shorten the positioning time,detect cuff displacement in time,and reduce the number of using of bronchoscopy,but MAP and HR increased higher during the induction period,intubation time was longer and intubation failure.