【Objective】 Our study was to compare the clinical performance and the effect of bronchial blocker and double-lumen tube on one lung ventilation in children undergoing thoracic surgery. 【Methods】 Fifty six children undergoing assisted thoracoscopic surgery were randomized into double-lumen tube group (DLT

n = 28) and bronchial blocker group (BB

n = 28). Anesthetic management and lung isolation were performed according to a standardized protocol. Changes of hemodymics were recorded. The time to initial lung isolation

intubation attempts

collapse score

the number of repositions of the lung isolation device after initial placement

airway pressures

tidal volumes

the arterial blood gases 20 min after pleural opening and duration of surgery were recorded. 【Results】 Compare with those in DLT

the time to initial lung isolation was longer

(173.1 ± 75.1) vs (95.6 ± 30.2) s

P < 0.05; collapse score was similar

peak airway pressure was higher

(28.11 ± 5.76) vs (21.57 ± 4.02) cmH2O

P < 0.05; arterial pH was lower (7.35 ± 0.03) vs (7.42 ± 0.06)

P < 0.05 and arterial PaCO2 was higher 20 min after pleural opening

(43.01 ± 7.25) vs (35.79 ± 3.17) mmHg

P < 0.05; the frequency of early postoperative hoarseness was less

14% vs 50%

P < 0.05; the frequency of early postoperative throat pain was less

35% vs 64%

P < 0.05. 【Conclusion】 The BB provided effective surgical exposure with less throat injuries in children during video-assisted thoracoscopic surgery.