Application of Tracheal Intubation in Lateral Position in Thoracic Surgery

NCT05482230 | Completed

• 1 other identifier: 2015299
• Study Type: interventional
• Target: 306
• Locations: 1 country
• Sites: 1

Brief Summary

This study investigated the incidence of bronchial blocker malposition in the lateral versus supine position and evaluated the effectiveness of lateral placement.

Conditions

Anesthesia; Tracheal Intubation; Thoracic Surgery

Keywords

Lateral Position; Bronchial occluder

Outcome Measures

Primary Outcomes (1)

• The incidence of bronchial blocker malposition.

  The incidence of bronchial blocker malposition in two groups S and L

  During surgery

Secondary Outcomes (9)

• The times of bronchial blocker reposition

  During surgery

• The duration of intubation

  During surgery

• The pressure of ventilation

  During surgery

• Intubation-related complications

  During surgery, after the patient regained full consciousness and before discharge from the post-anesthesia care unit, on the day after surgery, and 2 weeks postoperatively.

• Postural injuries

  These complications were assessed at three time points: after the patient regained full consciousness and before discharge from the post-anesthesia care unit, on the day after surgery, and 2 weeks postoperatively.

Study Arms (2)

Intubation and bronchial blocker placement performed in lateral position

EXPERIMENTAL

In the lateral position group, patients were positioned laterally (as required for surgery) before anesthesia induction. After anesthesia induction, both endotracheal intubation and bronchial blocker placement were performed while the patient remained in the lateral position.

Procedure: Intubation and bronchial blocker placement performed in lateral position

Intubation and bronchial blocker placement performed in supine position

NO INTERVENTION

Intubation and the placement of a bronchial blocker are typically carried out with the patient in the supine position, which is a standard procedure in thoracic surgery.

Interventions

Intubation and bronchial blocker placement performed in lateral position PROCEDURE

In the lateral position group, patients were positioned laterally (as required for surgery) before anesthesia induction. After anesthesia induction, both endotracheal intubation and bronchial blocker placement were performed while the patient remained in the lateral position.

Intubation and bronchial blocker placement performed in lateral position

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Years\<age ≥18 years;
• American Society of Anesthesiologists (ASA) physical status I-III;
• Undergo thoracic surgery requiring one-lung ventilation.

You may not qualify if:

• Risk of difficult intubation based on preoperative assessment (maximum mouth opening \<3 cm, body mass index \>30 kg/m2, limited neck movement, Mallampati grade IV, or main airway stenosis);
• Right upper bronchus originating at or above the tracheal carina;
• Plan to undergo bronchial sleeve resection, right upper lobectomy, or non-intubated thoracic surgery;
• Evidence or symptoms of acute lung or airway infection;
• History of thoracic surgery;
• Prior thoracic radiotherapy or chemotherapy;
• Preoperative upper extremity pain;
• Severe mental illness or difficulty with communication.

Sponsors & Collaborators

• xiangming fang: lead
• Red Cross Hospital, Hangzhou, China: collaborator
• The Central Hospital of Lishui City: collaborator
• Affiliated Hospital of Guangdong Medical University: collaborator
• Affiliated Hospital of Jiaxing University: collaborator
• Affiliated Hospital of Shaoxing University: collaborator
• Lishui Country People's Hospital: collaborator

Study Sites (1)

Jie Zhao

Hangzhou, Zhejiang, A0094, China

Location

Related Publications (13)

• Almeida C, Freitas MJ, Brandao D, Assuncao JP. [Use of bronchial blocker in emergent thoracotomy in presence of upper airway hemorrhage, and cervical spine fracture: a difficult decision]. Braz J Anesthesiol. 2018 Jul-Aug;68(4):408-411. doi: 10.1016/j.bjan.2017.09.004. Epub 2018 Jan 17.

  PMID: 29342420 BACKGROUND

• Lewis JW Jr, Serwin JP, Gabriel FS, Bastanfar M, Jacobsen G. The utility of a double-lumen tube for one-lung ventilation in a variety of noncardiac thoracic surgical procedures. J Cardiothorac Vasc Anesth. 1992 Dec;6(6):705-10. doi: 10.1016/1053-0770(92)90056-d.

  PMID: 1472668 BACKGROUND

• Komatsu R, Nagata O, Sessler DI, Ozaki M. The intubating laryngeal mask airway facilitates tracheal intubation in the lateral position. Anesth Analg. 2004 Mar;98(3):858-61, table of contents. doi: 10.1213/01.ane.0000100741.46539.6b.

  PMID: 14980953 BACKGROUND

• Goh SY, Thong SY, Chen Y, Kong AS. Efficacy of intubation performed by trainees on patients in the lateral position. Singapore Med J. 2016 Sep;57(9):503-6. doi: 10.11622/smedj.2015165. Epub 2015 Nov 13.

  PMID: 26768062 BACKGROUND

• Dimitriou V, Voyagis GS, Iatrou C, Brimacombe J. Flexible lightwand-guided intubation using the intubating laryngeal mask airway in the supine, right, and left lateral positions in healthy patients by experienced users. Anesth Analg. 2003 Mar;96(3):896-898. doi: 10.1213/01.ANE.0000048839.12552.50.

  PMID: 12598281 BACKGROUND

• Biswas BK, Agarwal B, Bhattacharyya P, Badhani UK, Bhattarai B. Intubating laryngeal mask for airway management in lateral decubitus state: comparative study of right and left lateral positions. Br J Anaesth. 2005 Nov;95(5):715-8. doi: 10.1093/bja/aei226. Epub 2005 Sep 2.

  PMID: 16143578 BACKGROUND

• Takenaka I, Aoyama K, Iwagaki T, Kadoya T. Efficacy of the Airway Scope on tracheal intubation in the lateral position: comparison with the Macintosh laryngoscope. Eur J Anaesthesiol. 2011 Mar;28(3):164-8. doi: 10.1097/EJA.0b013e328340c368.

  PMID: 20962657 BACKGROUND

• Jin Y, Ying J, Zhang K, Fang X. Endotracheal intubation under video laryngoscopic guidance during upper gastrointestinal endoscopic surgery in the left lateral position: A randomized controlled trial. Medicine (Baltimore). 2017 Dec;96(52):e9461. doi: 10.1097/MD.0000000000009461.

  PMID: 29384933 BACKGROUND

• Li H, Wang W, Lu YP, Wang Y, Chen LH, Lei LP, Fang XM. Evaluation of Endotracheal Intubation with a Flexible Fiberoptic Bronchoscope in Lateral Patient Positioning: A Prospective Randomized Controlled Trial. Chin Med J (Engl). 2016 Sep 5;129(17):2045-9. doi: 10.4103/0366-6999.189069.

  PMID: 27569229 BACKGROUND

• Lai HC, Wu ZF. Easier double-lumen tube placement using real-time video laryngoscopy and wireless video fiberoptic bronchoscopy. J Clin Anesth. 2019 Aug;55:132-133. doi: 10.1016/j.jclinane.2018.12.023. Epub 2019 Jan 15. No abstract available.

  PMID: 30658325 BACKGROUND

• Birring SS, Brew J, Kilbourn A, Edwards V, Wilson R, Morice AH. Rococo study: a real-world evaluation of an over-the-counter medicine in acute cough (a multicentre, randomised, controlled study). BMJ Open. 2017 Jan 16;7(1):e014112. doi: 10.1136/bmjopen-2016-014112.

  PMID: 28093442 BACKGROUND

• Saini S, Bhanot A, Kamal K, Bansal T. An improvised head support to facilitate endotracheal intubation in the lateral position. Acta Anaesthesiol Taiwan. 2015 Sep;53(3):109-11. doi: 10.1016/j.aat.2015.04.001. Epub 2015 Apr 24. No abstract available.

  PMID: 25987271 BACKGROUND

• Li H, Chu L, Ye H, Zhang Y, Li M, Hua Y, Zhang J, Hu H, Wen T, Zhao J, Wan H, Huang L, Lou Y, Tang J, Yan Z, Duan G, Wu J, Wang C, Lu Y, Shen X, Huang C, Song C, Wang Y, Zeng C, Xie G, Fang X. Lung isolation with a bronchial blocker placed in the lateral position for patients undergoing thoracic surgery: A multicenter, randomized clinical trial. J Clin Anesth. 2025 Jun;104:111869. doi: 10.1016/j.jclinane.2025.111869. Epub 2025 May 13.

  PMID: 40367865 DERIVED

MeSH Terms

Interventions

Intubation

Intervention Hierarchy (Ancestors)

Therapeutics; Investigative Techniques

Study Officials

• Xiangming Fang, Professor

  First Affilated Hospital of Zhejiang University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Chair Professor, Department of Anesthesiology Vice Dean, School of Medicine and and Pharmaceutical sciences Zhejiang University

Model Details: Intubation and bronchial blocker placement performed in lateral position.

Study Record Dates

• First Submitted: July 29, 2022
• First Posted: August 1, 2022
• Study Start: December 12, 2022
• Primary Completion: May 13, 2024
• Study Completion: May 30, 2024
• Last Updated: May 16, 2025

Record last verified: 2025-05

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL

Locations

CN (1)