The EZ-blocker for one-lung ventilation in patients undergoing thoracic surgery: clinical applications and experience in 100 cases in a routine clinical setting

J Cardiothorac Surg. 2018 Jun 25;13(1):77. doi: 10.1186/s13019-018-0767-9.


Background: In certain clinical situations the insertion of a double-lumen tube (DLT) for one-lung ventilation (OLV) is not feasible or unfavorable. In these cases, the EZ-Blocker (EZB) may serve as an alternative. The aim of our analysis was to report on the clinical applications and our experience with the EZB for one-lung ventilation in 100 patients undergoing thoracic surgery.

Methods: All anesthetic records from patients older than 18 years of age undergoing general anesthesia in the department of thoracic surgery with intraoperative use of an EZB for OLV at the University Hospital of Erlangen in four consecutive years were analyzed retrospectively.

Results: Most frequently, EZB was used in difficult airway (27%) and for surgical procedures with high risk for left recurrent laryngeal nerve injury (21%), followed by application in intubated (12%) or tracheostomized (11%) patients. 11% of the patients had an increased risk of gastric regurgitation. Almost all EZBs were placed free of complications (99%). Clinically sufficient lung collapse was achieved in all patients. No serious airway injuries or immediate complications were documented.

Conclusions: The EZB is an efficient, easy-to-use and safe airway device and enables OLV in several clinical situations, when conventional DLTs are not feasible or less favorable. Three major applications were depicted from the data: expected difficult airway, surgical procedures with necessity of intraoperative recurrent laryngeal nerve monitoring and already intubated or tracheostomized patients.

Keywords: Bronchial blocker; EZ-blocker; One-lung ventilation; Thoracic surgery.

MeSH terms

  • Aged
  • Anesthesia, General
  • Female
  • Humans
  • Intraoperative Period
  • Intubation, Intratracheal* / adverse effects
  • Male
  • Middle Aged
  • One-Lung Ventilation / instrumentation
  • One-Lung Ventilation / methods*
  • Pulmonary Atelectasis / etiology
  • Recurrent Laryngeal Nerve / pathology*
  • Respiration, Artificial / adverse effects
  • Retrospective Studies
  • Thoracic Surgical Procedures* / adverse effects
  • Tracheostomy