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About Importance Of Precise Placement Of Double – Lumen Tube During Anesthesia And Surgery


A double-lumen tube (DLT) is an endotracheal tube designed to isolate the lungs anatomically and physiologically. Double-lumen tubes (DLTs) are the most commonly used tubes to provide independent ventilation for each lung.


One-lung ventilation (OLV) or lung isolation is the mechanical and functional separation of the 2 lungs to allow selective ventilation of only one lung. The other lung that is not being ventilated passively deflates or is displaced by the surgeon to facilitate surgical exposure for non-cardiac operations in the chest such as thoracic, esophageal, aortic and spine procedures. It can also be used during minimally invasive cardiac surgery and in disease processes.


DLT is an essential equipment for thoracic anesthesia and its precise placement is particularly important for anesthesia and surgery.


Incidence of DLT malposition remains high and it leads to lung isolation failure and hypoxemia during one-lung ventilation.


In one such incidence, the Supreme Court directed Manipal Hospital to pay Rs 10 lakh compensation to the widow of a patient who developed hoarseness in his voice as a result of faulty insertion of a double lumen tube while administering anaesthesia. While the operating surgeon had assured the patient that the patient could regain his voice within 6-8 months with nebulization and voice therapy, the patient's voice was not restored and remained hoarse all through. The patient had virtually lost his voice.


Doctors opined that there was subluxation of the left arytenoid process, which happened due to wrong intubation during the anaesthesia procedure. It was found to be on account of the trauma caused leading to the paralysis of the vocal cord.

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