Application of Tracheal Intubation in Lateral Position in Thoracic Surgery

Study Overview
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Brief Summary
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This study is a pilot study of DLT or BB intubation using a visual laryngoscope in lateral position,To investigate the feasibility of DLT and BB intubation in lateral position,To compare the influence of four endotracheal intubation methods on intrapulmonary shunt,It provides safety guarantee for chest operation under spontaneous breathing anesthesia.

Detailed Description
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With the popularization of rapid rehabilitation medical treatment, the application of anesthesia techniques such as laryngeal mask anesthesia under spontaneous breathing and carbon dioxide artificial pneumothorax in thoracic surgery is gradually increasing,However, it is necessary to replace the double-lumen tracheal catheter in emergency situations such as massive bleeding or single-lung ventilation during surgery. At this time, it is particularly important to master the skills of lateral decubitus intubation, which can shorten the rescue time and is of great significance to thoracic anesthesia. Secondly, the movement of body position under anesthesia has an impact on hemodynamics and limb injury.In addition, the influence of anesthesia induction in different positions on patients' intrapulmonary shunt can also be considered.The above indicators, intubation time and success rate were observed,To analyze the feasibility and significance of lateral decubitus intubation in thoracic surgery.

Official Title
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Application of Visual Laryngoscope-guided Tracheal Intubation in Lateral Position in Thoracic Surgery:A Prospective, Multicenter, Large Sample, Randomized Controlled Study

Conditions
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Anesthesia, Tracheal Intubation, Thoracic Surgery

Intervention / Treatment
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* Other: Changes in intubation position


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients aged over than 18 years and less than 60 years The American Society of Anesthesiologists (ASA) score was grade Ⅰ to Ⅱ, and there was no serious cardiopulmonary disease Undergoing unilateral thoracoscopic surgery Exclusion Criteria: patients aged less than 18 years or over than 60 years BMI is over than 30kg/m2 patients have cognitive dysfunction and cannot coordinate with body position History of cervical vertebrae and expected difficult airway (e.g. Mallampati airway grade 4 or above, mouth opening <3 fingers, nail-chin distance <6cm) Patients were sent to ICU after operation and could not cooperate with follow-up

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: double-lumen tube or bronchial blocker in lateral position
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: DLT in supine position<br>The double-lumen bronchial group was inserted in supine position | |
| Experimental: DLT in lateral position<br>The double-lumen bronchial group was inserted in lateral position | Other: Changes in intubation position<br>* The change of intubation mode is accomplished in lateral position<br>|
| No Intervention: BB in supine position<br>The bronchial blocker group was inserted in supine position | |
| Experimental: BB in lateral position<br>The bronchial blocker group was inserted in lateral position | Other: Changes in intubation position<br>* The change of intubation mode is accomplished in lateral position<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intubation and location time | From the laryngoscope to the trachea tube main capsule into the target bronchus | During surgery | 
| Success rate of single intubation | A DLT or BB was successfully inserted into the target bronchus | During surgery | 
| Intubation displacement | Intubation displacement in different positions was recorded | During surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hemodynamic fluctuation | Hemodynamic fluctuations were recorded under different positions of intubation | During surgery | 
| QS pulmonary shunt | Intrapulmonary shunt in different positions was recorded | During surgery | 
| Cough score | Cough score in different positions was recorded | Within 3 days after surgery | 
| Grading of glottis exposure | Grading of glottis exposure in different positions was recorded | During surgery | 
| extremity and nerve injury | extremity and nerve injury in different positions was recorded | During surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Lateral Position, Double-lumen Tube, Bronchial occluder