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The investigators are trying to compare the individually modified-angled tube and the conventional-angled tube in ease of double lumen endotracheal tube insertion and the incidence of related postoperative complications.
Inserting a double lumen endotracheal tube is somewhat more difficult than a single lumen tube intubation because of its larger outer diameter and the more rigid feature. Moreover, the airway axes (oral-,pharyngeal-, and laryngotracheal axis) are not always straight under sniffing condition. Therefore, to make easy to insert a double-lumen tube and reduce the tube-related complications, we are trying to compare the individually angle-modified tube and the manufacturer-provided-angled tube.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control group | Active Comparator | Intubating a manufacturer-provided-angled double-lumen tube (=Conventional-angled group,"MallinckrodtTM endotracheal tube", Covidien) |
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| Tube angle modification | Experimental | The angle of the double lumen tube(MallinckrodeTM endotracheal tube) is modified individually.At sniffing position, the distal tip of the tube is placed at the patient's cricoid cartilage level and the tube is bent at the intersection point of the two airway axes (oropharyngeal axis and tracheal axis) with an angle between the two axes. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mallinckrodt endotracheal tube with a modified angle | Device | At sniffing position, the distal tip of a double-lumen tube is located at the patient's cricoid cartilage level and then the tube is bent at the intersection point of oral axis and the pharyngolaryngeal axis with an angle between the two axes. |
| Measure | Description | Time Frame |
|---|---|---|
| The time taken to intubate a double-lumen tube | The time taken to insert the tube begins when the laryngoscope passes the patient's lips and ends when the tube passes the vocal cords | within 60 sec |
| Measure | Description | Time Frame |
|---|---|---|
| The number of attempts needed for successful intubation | Intubation | |
| The time taken for the first attempt of intubation | within 60 sec | |
| Postoperative sore throat, hoarseness or dysphagia |
| Measure | Description | Time Frame |
|---|---|---|
| Hemodynamic change | We will record patient's heart rate, blood pressure and any used cardiovascular drugs at 1, 3 and 5 min after intubation | 1, 3 and 5 min after intubation |
| Intubation difficulty scale score |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jong Hwan Lee, MD,PhD | Samsung Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Samsung Medical Center | Seoul | 135-710 | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27537372 | Derived | Min JJ, Lee JH, Kang SH, Kim E, Lee SM, Cho JH, Kim HK. The Fast and Easy Way for Double-Lumen Tube Intubation: Individual Angle-Modification. PLoS One. 2016 Aug 18;11(8):e0161434. doi: 10.1371/journal.pone.0161434. eCollection 2016. |
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| Mallinckrodt endobronchial tube with a conventional angle | Device | Inserting a manufacturer-provided conventional-angled tube |
|
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| 30 minutes and 24hours after extubation |
Intubation difficulty Scale score is a function of seven parameters : number of attempts, number of operators, number of alternative techniques, cormack grade, lifting force needed, laryngeal pressure and vocal cord mobility.
(Ref: Intubation Difficulty Scale, Anesthesiology 1997;87:1290-7)
| At intubation |