Bronchial blocker positioning: learning curve and confidence in its use

Minerva Anestesiol. 2018 Nov;84(11):1254-1260. doi: 10.23736/S0375-9393.18.12390-X. Epub 2018 Jan 17.

Abstract

Background: Despite being simple and safe to use and cheap, EZ blocker (EZB) remains underused probably because it requires particular skills in recognizing airway and in using fiber-bronchoscopy to check the exact position of their cuffs. Thus, we planned an education training program on the use of EZB for novices in anesthesia and evaluated the number of procedures required for the acquisition of the skills of this technique.

Methods: The educational training program included three different phases as follows. The first phase included a lecture on the utility of one-lung ventilation in thoracic surgery, on the use of the fiber- bronchoscopy and on the characteristics of EZB. The second phase consisted in a practical teaching course performed on a manikin model to acquire the skills in EZB. The third phase was a clinical training where each participant performed a defined number in patients scheduled for thoracic surgery procedures. The acquisition of dexterity and satisfaction were then statistically valuated.

Results: The dexterity in placing EZB significantly increased after six attempts (P<0.1). Participants acquired skills in correcting position EZB after 15 attempts. Participants increased their level of confidence with EZB (score 5.7±1.3) and were highly satisfied with the training received (score 5.8±1.6).

Conclusions: EZB is a valid strategy for obtaining one lung ventilation. Thus, it should be included in the armamentarium of all anesthetists interested in the field of thoracic surgery. Our teaching course seems to be a valuable method to instill easily and speedily in training novices in anesthesia the skills in placing EZB.

Publication types

  • Observational Study

MeSH terms

  • Anesthesiology / education*
  • Bronchi
  • Clinical Competence
  • Equipment Design
  • Humans
  • Learning Curve*
  • One-Lung Ventilation / instrumentation
  • One-Lung Ventilation / methods*