Measuring incisor-carina distance by fiberoptic bronchoscopy to guide the placement of a left-sided double-lumen endobronchial tube

The aim of this randomized observational study was to evaluate the effect of measuring the incisor-carina distance by fiberoptic bronchoscopy in guiding the placement of a left-sided double-lumen endobronchial tube. Fifty patients (American Society of Anesthesiologists class I-II) undergoing elective thoracic procedures requiring single-lung ventilation using a left-sided double-lumen endobronchial tube were evaluated. Patients were randomly divided into either group M, in which a left-sided double-lumen endobronchial tube was placed by measuring the incisor-carina distance with fiberoptic bronchoscopy, or group B, in which the endobronchial tube was placed by blind insertion and then confirmed with fiberoptic bronchoscopy. After placement, tube position was assessed by fiberoptic bronchoscopy and cases requiring adjustment were recorded. The intubation time and postoperative adverse reactions related to intubation were also recorded. We conclude that compared with blind placement, this method can reduce total intubation time, increase the rate of accurate placement, and reduce the incidence of adverse reactions related to intubation. It is relatively simple and reliable, and is useful in clinical application.