A comparison of two types of new bronchial blockers, Uniblocker™ and Coopdech endotracheal blocker tube, for one-lung ventilation during thoracoscopy

Introduction

The purpose of this study was to compare the use of a wire-guided bronchial blocker, Uniblocker™ (Fuji Systems Corporation, Tokyo, Japan), with a spread type of bronchial blocker, Coopdech endotracheal blocker tube (Daiken Medical Corporation, Osaka, Japan), for lung isolation during elective thoracic surgical cases.

Materials and methods

Twenty ASA I-II patients signed written informed consent before being enrolled into the study. We designed a prospective, randomized trial to compare the effectiveness of lung isolation among the two types of bronchial blockers: Uniblocker™ group (UBB; n = 10), and Coopdech endotracheal blocker tube group (CBB; n = 10). Patients were randomized to intubate with a single-lumen tube with concomitant use of a UBB or a CBB. Both groups were subdivided in two: bronchial blocker placed in the right mainstem bronchus (UBBR/CBBR), and in the left mainstem bronchus (UBBL/CBBL). Comparisons between groups included: (1) the number of unsuccessful placement attempts with the blinded insertion technique, (2) the number of malpositions of the devices, (3) the time required to place the device in the correct position, (4) surgical satisfaction with the lung deflation, (5) complications and (6) the quality of lung deflation.

Results

The number of unsuccessful placement attempts was none in the UBBR group (0/10) and one in the CBBR group (1/10), two in the UBBL group (2/10) and five in the CBBL group (5/10). A fiberoptic aided technique should be more appropriate for the left-sided blocker in both groups. There was no statistical difference in bronchial blocker malpositions, the lung to collapse and the number of complications among the two groups. Furthermore, for elective thoracic surgical cases, once the lung was isolated, the management seemed to be similar for both groups.

Discussion

This study demonstrates that the wire-guided bronchial blocker (Uniblocker™) provides a high torque control and can be easily manipulated into the desired site of the lungs. In conclusion, our study shows that the Uniblocker™ is more useful than the Coopdech bronchial blocker tube.