Efficacy of Arndt Endobronchial blocker and Left Double-Lumen tube in lung isolation for thoracic surgery: a randomized comparative study

Background: Thoracic surgery often needs one-lung ventilation (OLV) and lung separation for optimal surgical exposure. Double-lumen tube (DLT) intubation is the most frequent technique, while bronchial blockers (BB), such as the wire-guided Arndt BB, offer an alternative, especially in difficult airways. Aim: To compare the effectiveness of the Arndt endo BB and the DLT in achieving lung collapse during thoracic surgery. Patients and Methods: This prospective, randomized controlled research involved sixty cases that underwent elective thoracic surgery, divided into two groups: Group D (DLT, n=30) with a left double-lumen tube, and Group A (Arndt BB, n=30) with an Arndt endobronchial blocker for lung isolation. Results: The success rate of intubation attempts was similar among the two groups (p=0.646). However, intubation and device placement time were significantly shorter in the DLT group (82.22 ± 14.95 s) compared to the Arndt BB group (140.35 ± 15.59 s, p < 0.001). Lung collapse grades showed no significant difference (p=0.194): spontaneous (grade I) occurred in 80% vs. 60%, assisted (grade II) in 10% vs. 26%, and manual (grade III) in 10% vs. 13.3% for DLT and BB groups, respectively. Surgeon satisfaction was also comparable (p=0.539). Postoperative hoarseness was significantly higher with DLT (30% vs. 6.7%, p=0.029), as was sore throat (20% vs. 6.7%, p=0.034). Conclusion: The Arndt blocker is utilized as a good change to the left double-lumen tube for single-lung ventilation during thoracic operations.