• Weikang Shui, Wei Hu, Wenwen Ma, Yuting Han, Ian Yifei Hao, Shiyao Zhu, Yuefeng Sun, Zhijie Deng, Ya Gao, Lei Heng, and Shanshan Zhu.
• From the Jiangsu Province Key laboratory of Anaesthesiology, Xuzhou Medical University (WS, WH, YS, ZD, SZ), Department of Anaesthesiology, Xuzhou Cancer Hospital, Xuzhou (WM, YH, SZ, LH, SZ), California State University, Los Angeles, USA (IYH) and Jiangsu University, Zhenjiang, Jiangsu, China (YG).
• Eur J Anaesthesiol. 2024 Apr 1; 41 (4): 305313305-313.

BackgroundTracheal injuries, vocal cord injuries, sore throat and hoarseness are common complications of double-lumen tube (DLT) intubation.ObjectiveThis study aimed to evaluate the effects of 'video double-lumen tubes' (VDLTs) on intubation complications in patients undergoing thoracic surgery.DesignA randomised controlled study.SettingtXuzhou Cancer Hospital, Xuzhou, China, from January 2023 to June 2023.PatientsOne hundred eighty-two patients undergoing elective thoracic surgery with one-lung ventilation were randomised into two groups: 90 in the DLT group and 92 in the VDLT group.InterventionVDLT was selected for intubation in the VDLT group, and DLT was selected for intubation in the DLT group. A fibreoptic bronchoscope (FOB) was used to record tracheal and vocal cord injuries.Main Outcome MeasuresThe primary outcomes were the incidence of moderate-to-severe tracheal injury and the incidence of vocal cord injury. The secondary outcomes included the incidence and severity of postoperative 24 and 48 h sore throat and hoarseness.ResultsThe incidence of moderate-to-severe tracheal injury was 32/90 (35.6%) in the DLT group, and 45/92 (48.9%) in the VDLT group ( P  = 0.077; relative risk 1.38, 95% CI, 0.97 to 1.95). The incidence of vocal cord injury was 31/90 (34.4%) and 34/92 (37%) in the DLT and VDLT groups, respectively ( P  = 0.449). The incidence of postoperative 24 h sore throat and hoarseness was significantly higher in the VDLT group than in the DLT group (for sore throat: P  = 0.032, relative risk 1.63, 95% CI, 1.03 to 2.57; for hoarseness: P  = 0.018, relative risk 1.48, 95% CI, 1.06 to 2.06).ConclusionThere was no statistically significant difference in the incidence of moderate-to-severe tracheal injury and vocal cord injury between DLTs and VDLTs. While improving the first-attempt success rate, intubation with VDLT increased the incidence of postoperative 24 h sore throat and hoarseness.Trial RegistrationChinese Clinical Trial Registry identifier: ChiCTR2300067348.Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Society of Anaesthesiology.

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