• Jiang Yan, Zhang Rufang, Wei Rong, and Zhang Wangping.
• Department of Anesthesiology, Shanghai Children's Hospital, Shanghai JiaoTong University, Shanghai, China.
• J. Cardiothorac. Vasc. Anesth. 2020 Sep 1; 34 (9): 2435-2439.

ObjectiveThe purpose of the present study was to evaluate the efficacy of extraluminal use of the bronchial blocker (BB) for one-lung ventilation (OLV) in infants undergoing thoracoscopic surgery.DesignThis was a prospective, randomized, controlled clinical study.SettingUniversity hospital.ParticipantsThe study comprised 60 infants undergoing thoracoscopic surgery.InterventionThe study included 2 groups. A BB was placed extraluminally for OLV in group A, and a single-lumen endobronchial tube was inserted into the desired mainstem bronchus for OLV in group C.Measurements And Main ResultsThe placement time (4.0 ± 0.6 min v 6.3 ± 4.1 min; p = 0.04) and the number of repositions (2 v 11; p = 0.005) were less in group A. There were significant differences in the heart rate and blood pressure after insertion between the 2 groups (p < 0.05). The tidal volumes and end-tidal pressure of carbon dioxide values 10 minutes after the initiation of OLV were similar between the 2 groups (p > 0.05). The incidence of intraoperative hypoxemia was reduced in group A compared with group C (0% v 20%; p = 0.024). No postoperative adverse events were observed in either group.ConclusionsExtraluminal use of the BB may provide a solution for a rapid placement and excellent quality of lung isolation, and it may reduce the incidence of intraoperative hypoxemia in infants without increasing the incidence of hoarseness.Copyright © 2020 Elsevier Inc. All rights reserved.

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