Çift lümenli tüp yerleşiminin fiberoptik bronkoskopi ile doǧrulanmasi

Aim: DLET's are essential for one lung ventilation. Confirmation of the placement after intubation with clinical evaluation might give 34-78 % wrong results. Control of the DLET's with fiberoptic bronchoscope might reduce the wrong placement and related complications. In this study, we present our results of verifying DLET's position with FOB. Material and Method: ASA I-III, 40 patients aged between 20-75 who underwent elective thoracic surgery were included the study. All patients premedicated with 0.5 mg atropine and 25 mg meperidine intramuscularly. After the monitorization of ECG, pulse oximetry, non-invasive blood pressure, preoxygenation with 100 % oxygen was obtained in all patients. After induction with 6 mg kg ^-1 pentothal and 1 μg kg ^-1 fentanyl, 0.1 mg kg ^-1 vecuronium was used for muscle relaxation. Intubation with left or right DLET according to the planned surgery was made by the same anesthesiologist. 50 % O ₂, 50 % N ₂O and 1-1.5 % isoflurane were used for anesthesia maintenance. All patients' heart rate, blood pressure, end tidal CO ₂ measurements, possible side effects, used medications was followed during confirmation period with FOB. Patient were mechanically ventilated with volume controlled mode to obtain the end tidal CO ₂ between 30-35 mmHg. The positions of DLET's were first evaluated with conventional clinical evaluation and after this FOB were used for confirmation of the placement. Results: 35 patient undergoing thoracotomy, 5 patient undergoing video assisted thoracoscopic surgery were included to the study. 22 patients were intubated with left, 18 patients were intubated with right DLET. The demographic data of groups were found to be similar. The clinical evaluation and confirmation with FOB time was 350.0±109.8 sec for left DLET's, 336.6±89.2 sec for right DLET's. In right DLET clinical evaluation revealed % 22.2, FOB revealed 33.3 % wrong placement. In left DLET clinical evaluation revealed % 4.4, FOB revealed 13.6 % wrong replacement. Conclusion: FOB is necessary to confirm the tube position and this result supports the other studies suggesting the routine usage of FOB in DLET intubation.