Effects of Thermal Softening on Laryngeal Complications Associated with Double-Lumen Endobronchial Tube Insertion: A...

Double-lumen endobronchial tube (DLT) is a widely used anesthetic technique in lung surgery; however, it often leads to laryngeal complications that negatively impact postoperative recovery. This study aims to thoroughly investigate the efficacy of thermal softening technology in reducing the incidence of postoperative sore throat (POST), hoarseness, vocal cord injuries, and intubation resistance.

A systematic review and meta-analysis of randomized controlled trials.

As of September 2024, two independent reviewers systematically searched PubMed, EMBASE, and the Cochrane Library, employing Review Manager 5.4 for meta-analysis and subgroup analysis. Potential publication bias was evaluated through Egger's and Begg's tests. Additionally, the of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was utilized to assess the certainty of the evidence collected.

A total of 1257 relevant articles were identified, of which 4 were included in the comprehensive analysis. Statistical results indicate high-quality evidence supporting that thermal softening of DLTs can significantly reduce intubation resistance (RR = 0.36, CI = 0.22-0.61, I² = 68%, P = .0001) and subsequently decrease the incidence of POST (RR = 0.59, CI = 0.47-0.75, I² = 38%, P < .0001), hoarseness (RR = 0.73, CI = 0.54-0.98, I² = 19%, P = .04), and vocal cord injuries (RR = 0.51, CI = 0.41-0.64, I² = 20%, P < .00001).

This research supports the use of thermal softening technology as a non-pharmacological approach to mitigate laryngeal complications associated with double-lumen tracheal intubation.