A case of single-lung ventilation using bronchial blocker in pediatric patient

A 6-year-old, 116 cm, 24 kg boy was scheduled to undergo left inferior lobectomy for pulmonary sequestration. General anesthesia was induced by inhaled sevoflurane in nitrous oxide and oxygen. Muscle relaxation was achieved with vecuronium and then tracheal intubation was performed. Initially bronchial blocker cut off from Univent® placed in the trachea, and then 5.0 mm-ID, cuffed endotracheal tube was intubated alongside the bronchial blocker, and finally bronchial blocker was advanced into left main bronchus using bronchoscope. Subsequently, the child was ventilated through the endotracheal tube with an inflated balloon, and anesthesia was maintained by sevoflurane in nitrous oxide and oxygen supplemented by fentanyl. SpO₂ was 97-99% during 2.5 hours of single-lung ventilation with 50% oxygen. He was extubated after recovery from anesthesia without complication. Single-lung ventilation in children younger than 8-10 years old requires some devices because endotracheal tube for single-lung ventilation available is too big for them. This bronchial blocker cut off from Univent® is recommended for some pediatric patient with single-lung ventilation.