Study protocol for a randomized controlled trial assessing the effect of lateral position intubation on bronchial blocker placement during unilateral video-assisted thoracic surgery

Abstract

Background: Approximately one-third of patients who undergo bronchial blocker (BB) intubation in the conventional supine position suffer BB malposition. This trial aims to explore the efficiency and clinical application of BB intubation in the lateral position to reduce the incidence of BB malposition in patients undergoing video-assisted thoracic surgery (VATS). Methods: This single-center, parallel-group, randomized controlled trial will enroll 110 patients aged 18–80 years who are scheduled for elective unilateral VATS with BB intubation under general anesthesia. Participants will be randomly assigned (1:1) to either the lateral BB intubation group or the conventional supine BB intubation group. The primary outcome is the incidence of BB malposition observed by fiberoptic bronchoscopy (FOB). Secondary outcomes include the duration of intubation, the frequency and duration of FOB usage, whether to re-intubate, intraoperative vital signs, and postoperative recovery. Discussion: This trial will confirm the clinical efficacy and superiority of BB intubation in the lateral position to consolidate the lateral intubation pattern in thoracic anesthesia. We expect that performing lateral BB intubation can reduce the BB malposition rate and result in more stable intraoperative vital signs and fewer postoperative complications, which is in line with the concept of Enhanced Recovery After Surgery in thoracic anesthesia. Trial registration: Chinese Clinical Trial Registry ChiCTR2400081961. Registered on March 18, 2024.