Anaesthetic equipment for thoracic surgery

One-lung anaesthesia is becoming an increasing necessity for thoracic operations. Knowledge of the required apparatus is essential for anaesthetists. Developed in the 1950s from apparatus for measuring individual lung function, the double-lumen endobronchial tube remains the most widely used piece of equipment in this field. The early red rubber tubes are giving way to those of modern plastic materials, but the principles and function of the double-lumen tube remain unchanged. Positioning the tubes has been improved by the introduction of robust fine fibre-optic bronchoscopes in recent years. However, the old principle of the bronchus blocker has also made a comeback recently, stimulated by the availability of new materials and better fibre-optic bronchoscopy. This article outlines the development and use of the currently available double-lumen tubes, together with the use of the bronchus blockers on the market at present. It concludes with some comparisons between the two methods of lung isolation.