Abstract

Double-lumen tubes (DLTs) are essential tools for achieving lung isolation during thoracic surgeries, allowing for differential ventilation of the lungs and facilitating surgical access and visualization. This paper aims to compare and evaluate these techniques to guide clinical decision-making and improve patient care in thoracic surgery. Materials and Methods- Forty adult patients scheduled for elective thoracic surgery requiring lung isolation with a double-lumen endotracheal tube (DLT) were recruited for this study. Two DLT insertion techniques, Conventional technique and Modified technique were compared among 40 patients on the points, Time taken for DLT insertion which was divided into T1 and T2, Ease of insertion: Easy, Difficult, Failure, Number of attempts, Incidence of trauma, Use of BURP maneuver (Backward, Upward, Rightward Pressure), Conversion to the Modified technique/ Conventional technique, Blood pressure and Heart rate were recorded at different intervals, Intraoperative respiratory parameters were monitored and recorded Outcome Measures:- Trauma, Assessment of Postoperative Symptoms:-Sore Throat, Odynophagia, Hoarseness. Bronchospasm and Arrhythmia. Results- The patient demographic data collected were broadly comparable and no significant difference was observed in the demographic data of the two groups studied. There were no significant differences between the upper airway characteristics of each group studied i.e., the Mouth opening, Thyromental distances, the modified Mallampati score, and Cormack-Lehane grade. The comparison between the conventional and modified techniques were made in terms of time taken T1 and T2 (in seconds), Attempts taken, Trauma during insertion, BURP Maneuver, and EASE of insertion which was found to be better in modified technique as compared to conventional technique. For hemodynamics -the modified technique does not significantly alter hemodynamic parameters compared to the conventional technique, as evidenced by the non-significant P values across all comparisons. Incidence of hoarseness and sore throat was found to be low in the Modified Technique compared to the Conventional Technique. We observed no statistically significant difference in Odynophagia severity between the two Techniques. Conclusion- our study highlights the significant advantages of a Modified technique for double-lumen tube (DLT) insertion compared to Conventional approaches. By shaping the DLT to mimic a standard endotracheal tube and keeping the stylet in place, the Modified technique streamlines the insertion process, reducing procedural time, minimizing trauma, and requiring fewer attempts for successful placement

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