• J. Cardiothorac. Vasc. Anesth. · Aug 2021

    Randomized Controlled Trial

    A Randomized Comparison of Positional Stability: The EZ-Blocker Versus Left-Sided Double-Lumen Endobronchial Tubes in Adult Patients Undergoing Thoracic Surgery.

    • Benjamin N Morris, Rohesh J Fernando, Chandrika R Garner, Sean D Johnson, Jeffrey C Gardner, Bryan E Marchant, Kathleen N Johnson, Hannah M Harris, Gregory B Russell, L James Wudel, and T Wesley Templeton.
    • Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC. Electronic address: bmorris@wakehealth.edu.
    • J. Cardiothorac. Vasc. Anesth. 2021 Aug 1; 35 (8): 2319-2325.

    ObjectiveTo assess if there is a difference in the repositioning rate of the EZ-Blocker versus a left-sided double-lumen endobronchial tube (DLT) in patients undergoing thoracic surgery and one-lung ventilation.DesignProspective, randomized.SettingSingle center, university hospital.ParticipantsOne hundred sixty-three thoracic surgery patients.InterventionsPatients were randomized to either EZ-Blocker or a DLT.Measurements And Main ResultsThe primary outcome was positional stability of either the EZ-Blocker or a left-sided double-lumen endobronchial tube, defined as the number of repositionings per hour of surgery and one-lung ventilation. Secondary outcomes included an ordinal isolation score from 1 to 3, in which 1 was poor, up to 3, which represented excellent isolation, and a visual analog postoperative sore throat score (0-100) on postoperative days (POD) one and two. Rate of repositionings per hour during one-lung ventilation and surgical manipulation in left-sided cases was similar between the two devices: 0.08 ± 0.15 v 0.11 ± 0.3 (p = 0.72). In right-sided cases, the rate of repositioning was higher in the EZ-Blocker group compared with DLT: 0.38 ± 0.65 v 0.09 ± 0.21 (p = 0.03). Overall, mean isolation scores for the EZ-Blocker versus the DLT were 2.76 v 2.92 (p = 0.04) in left-sided cases and 2.70 v 2.83 (p = 0.22) in right-sided cases. Median sore throat scores for left sided cases were 0 v 5 (p = 0.13) POD one and 0 v 5 (p = 0.006) POD two for the EZ-Blocker and left-sided DLT, respectively.ConclusionFor right-sided procedures, the positional stability of the EZ-Blocker is inferior to a DLT. In left-sided cases, the rate of repositioning for the EZ-Blocker and DLT are not statistically different.Copyright © 2020 Elsevier Inc. All rights reserved.

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