Comparison of double lumen endobronchial tubes with single lumen endobronchial tubes in one lung ventilation applications

Objective: The primary aim of this study is to compare the effects of double-lumen endobronchial tube (D-LET) and single-lumen endobronchial tube (S-LET) applications used for intubation on postoperative sore throat and hoarseness in thoracic surgery patients who will undergo one lung ventilation (OLV). Secondary purposes are to compare the clinical data of the newly introduced S-LETs with DLETs, such as the insertion time, perioperative malposition, and whether they provide adequate lung collapse. Design and Method: A single-center, prospective observational study included 56 patients with ASA I-III, aged 18-80 years and undergoing elective thoracic surgery. Patients were divided into the following two groups: The D-LET's group (Group D, n=28) and S-LET's group (Group S, n=28). The correct tube size for D-LET was determined by the combined method by measuring the cricoid diameter and main bronchus diameter on CT. It was planned to use S-LETs with a diameter of 7.5 mm in women and 8 mm in men. The incidence and severity of sore throat and hoarseness were evaluated at the postoperative 1st, 24th and 48th hours after extubation. Results: The incidence and severity of sore throat and hoarseness at all measurement times; Compared to Group S, there was no statistically significant difference, although it was higher in Group D. Post-intubation placement times and lung collapse quality were similar in both groups. A statistically significant difference was found between the two groups in terms of malposition and hypoxia. While hypoxia was observed in 4 patients in Group S, it was not observed in Group D (p=0,038). Malposition was observed in 11 patients in Group S and 4 patients in Group D (p=0,035). Conclusions: Although S-LETs produced less sore throat and hoarseness compared to D-LETs, this difference was not statistically significant. No severe sore throat or hoarseness was reported with any method. More perioperative malposition and associated hypoxia were observed in S-LETs. The insertion times and lung collapse quality of both methods were found to be similar. As a result, although S-LETs are thinner and softer, no superiority to DLETs was found in terms of sore throat and hoarseness. Although the insertion times and lung collapse qualities are the same, S-LETs cause more malposition during OLV. There is a need for increased experience of S-LET use and future randomized controlled studies with higher subjects. Keywords: one-lung ventilation; thoracic surgery; sore throat; double-lumen endobronchial tube; single-lumen endobronchial tube; hoarseness; malposition