A randomized comparison of positional stability: The EZ-blocker® versus left-sided double lumen endobronchial tube in adult patients for thoracic surgery

Abstract Objective : To assess if there is a difference in the repositioning rate of the EZ-Blocker® versus a left-sided double lumen endobronchial tube(DLT) in patients undergoing thoracic surgery and one lung ventilation(OLV). Design : Prospective, Randomized Setting : Single Center, University Hospital Participants : 163 thoracic surgery patients Interventions : Patients were randomized to either EZ-Blocker® or a DLT. Measurements and Main Results : The primary outcome was positional stability of either the EZ-Blocker or a left sided double lumen endobronchial tube defined as the number of repositionings per hour of surgery and one lung ventilation. Secondary outcomes included an ordinal isolation score from 1-3, where 1 was poor up to 3 which represented excellent isolation and a visual analog postoperative sore throat score (0-100) on postoperative days(POD) 1 and 2. Rate of repositionings per hour during OLV and surgical manipulation in left-sided cases was similar between the two devices: 0.08±0.15 versus 0.11± 0.3(p=0.57). In right sided cases, the rate of repositioning was higher in the EZ-Blocker® group compared to DLT: 0.38±0.65 versus 0.09±0.21(p=0.01). Overall, mean isolation scores for the EZ-Blocker versus the DLT were 2.64 vs 2.86(p=0.001) in left sided cases and 2.61 vs 2.81(p=0.01) in right side cases. Median sore throat scores were 0 vs 5 (P=0.13) POD 1 and 0 vs 5 (P=0.006) POD 2 for the EZ-Blocker® and left-sided DLT, respectively. Conclusion : For right-sided procedures, the positional stability of the EZ-Blocker® is inferior to a DLT. In left-sided cases, the rate of repositioning for the EZ-Blocker® and DLT are not statistically different.