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Chapter 27 - Thoracic anaesthesia

from Section 3 - Specialties

Published online by Cambridge University Press:  10 January 2011

By
Adrian Pearce
Edited by
Ian Calder  and
Adrian Pearce
Ian Calder
Affiliation:
National Hospital for Neurology and Royal London Hospital
Adrian Pearce
Affiliation:
Guy's and St Thomas' Hospital, London
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Summary

A major component of safe thoracic anaesthesia is the appropriate use of endobronchial tubes, double-lumen tubes (DLTs) and bronchial blockers. A bronchial blocker is effectively a small balloon on a long catheter with a central lumen which, when placed endobronchially, occludes ventilation on that side and allows egress of gas from the isolated lung. Placement of DLT is awkward than a single lumen tube, and a difficult airway produces additional complexity. The introducer is a useful aid to intubation with single lumen tube by direct laryngoscopy but the normal introducer is too short to place a DLT in the same manner. The tube exchange catheters are supplied with rapi-fit connectors to allow low or high pressure ventilation in case of difficulty or desaturation during the tube exchange. Oral flexible fibreoptic intubation with DLT is a possible solution, and the fibrescope can be used to place it in the correct bronchus.

Keywords

anaesthetic drugsemergency cricothyroidotomylarge bore cannula devicestracheasurgical cricothyroidotomysmall cannula deviceslost airway
Type
Chapter
Information
Core Topics in Airway Management , pp. 255 - 261
Publisher: Cambridge University Press
Print publication year: 2010

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