Abstract: Aim: To compare the ease of lung isolation using a double-lumen tube (DLT) versus a bronchial blocker (BB) in terms of the number of attempts, need for bronchoscope assistance, and incidence of airway trauma in patients undergoing thoracic surgery.

Materials &Methods: This prospective observational study included 100 patients aged 18–65 years undergoing elective thoracic surgery requiring lung isolation. Patients were randomized into two groups: Group DLT (n = 50) underwent lung isolation with a double-lumen tube, and Group BB (n = 50) with a bronchial blocker. General anesthesia with a standardized protocol was administered, and procedures were performed by experienced anesthesiologists. Outcome measures included the number of attempts required for successful lung isolation, bronchoscope usage, and airway trauma assessed immediately and 24 hours postoperatively. Data were analyzed using Student’s t-test and chi-square tests, with p-values <0.05 considered significant.

Results: Group DLT achieved significantly higher first-attempt success rates (90.0% vs. 74.0%, p = 0.04) and required fewer attempts (1.10 ± 0.30 vs. 1.32 ± 0.56, p = 0.03). Bronchoscope use was less frequent in Group DLT (24.0% vs. 82.0%, p < 0.001), with shorter bronchoscope time (3.5 ± 1.2 min vs. 6.8 ± 1.6 min, p < 0.001). Airway trauma was more common in Group BB (36.0% vs. 18.0%, p = 0.03), and Group DLT had significantly shorter procedure times (8.2 ± 2.1 min vs. 11.5 ± 3.2 min, p < 0.001). Patient and surgeon satisfaction scores were significantly higher in Group DLT.

Conclusion: Double-lumen tubes (DLTs) are more efficient and reliable than bronchial blockers (BBs) for lung isolation, with higher first-attempt success rates, reduced bronchoscope dependence, shorter procedure times, and lower airway trauma rates. DLTs are better suited for routine thoracic surgeries, while BBs remain valuable for specific scenarios requiring flexible approaches.