DOUBLE LUMEN INTUBATION

Auscultation is well established and most commonly used method for checking of correct placement ofDouble Lumen Tube(DLT). Now with widespread availability of fibre optic bronchoscope, confirmation of DLT placement by fibre opticbronchoscope is recommended by many and considered mandatory by some anaesthetist. Objective: To discuss method of insertion andreliability of auscultatory method to confirm correct placement of double lumen tubes. S t u d y d e s i g n : Observational. Place a n d d u r a t i o n:Combined Military Hospital Rawalpindi from 16th Nov 2003 to 13th July 2007. Material & M e t h o d s . We have performed about one thousandone hundred and fifty double lumen intubation without use of fibreoptic bronchoscope. Results: 85% of patients did not need any tubeadjustment during surgical procedure. Only 15% cases required tube adjustment intra-operatively. None of procedures were abandoneddue to double lumen tubes problems. C o n c l u s i o n : We conclude that auscultation is not that unreliable though not perfect method of DLTplacement. Use of fibreoptic bronchoscope is recommended but not mandatory for DLT placement. Anatomical malpositioning detected byfibre optic bronchoscope which according to some studies is 70 to 80% does not necessarily translate into physiological malfunctioning.