The effect of laryngeal mask combined with bronchial occluder in patients undergoing single lung ventilation in thoracic surgery: A retrospective study

Abstract

This study evaluates the clinical efficacy of combining a laryngeal mask airway with a bronchial blocker (LMA-BB) in single-lung ventilation (OLV) during thoracic surgery compared to the traditional single-lumen tracheal tube with a bronchial blocker (single-lumen tracheal tube [SLT] + BB). A retrospective analysis was performed on 93 patients undergoing thoracic surgery with OLV from December 2021 to September 2023. After propensity score matching (1:1), 34 patients remained in each group (LMA-BB and SLT + BB). Key outcomes, including airway pressures, ventilation and oxygenation parameters, lung compliance, postoperative recovery, and complications, were compared between groups. After matching, the 2 groups had similar baseline characteristics. The LMA-BB group showed significant advantages in airway pressure management, with lower peak and plateau pressures ( P < .05). Ventilation and oxygenation efficiency were superior in the LMA-BB group, including lower end-tidal carbon dioxide (37.8 ± 4.7 vs 39.2 ± 5.1 mm Hg, P = .04) and higher oxygenation index (255 ± 22 vs 245 ± 28, P = .04). Lung compliance was improved ( P = .018), and more patients in the LMA-BB group achieved excellent lung collapse (76.5% vs 52.9%, P = .032). Additionally, postoperative recovery was faster, with shorter extubation times (12.4 ± 3.2 vs 14.8 ± 3.6 minutes, P = .003) and fewer complications, including hypoxemia (5.9% vs 23.5%, P = .027) and pulmonary issues (8.8% vs 20.6%, P = .046). The LMA-BB technique offers significant clinical benefits over the traditional SLT + BB method in thoracic OLV, including improved airway management, ventilation efficiency, lung compliance, and faster recovery. It also reduces postoperative complications, making it a promising alternative for thoracic surgery.