Endobronchial ultrasound-guided transbronchial needle aspiration, patient satisfaction under light conscious sedation

Abiramy Jeyabalan, Andrew R L Medford

Research output: Contribution to journalArticle (Academic Journal)peer-review

20 Citations (Scopus)

Abstract

BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an increasingly used mediastinal sampling technique. Many centres use conscious sedation in an ambulatory setting to optimise the flow of patients, save costs and shorten recovery time. The only EBUS-TBNA patient satisfaction study published so far used deep conscious sedation with propofol. To our knowledge, ours is the largest prospective study evaluating the experience of patients undergoing EBUS-TBNA using light conscious sedation without propofol.

OBJECTIVES: To evaluate the patient tolerability of EBUS-TBNA under mild conscious sedation.

METHODS: Eighty-two consecutive patients between January 2011 and November 2011 requiring EBUS-TBNA under light conscious sedation for either mediastinal staging of lung cancer or the diagnosis of suspected mediastinal disease due to malignancy or granulomatous disease were invited to complete a questionnaire after the intervention. The collection of data included the diagnostic yield, the number and size of nodes sampled and the dose of sedative medication administered.

RESULTS: The average dose of sedative agents administered was 59.4 μg fentanyl and 3.2 mg midazolam. The sensitivity of EBUS-TBNA for the cancer staging, cancer diagnosis and granulomatous disease cohorts was 90.0, 94.1 and 87.5%, respectively. The most commonly reported symptom was a cough in 65 (93%) patients. Of these patients, 46 (71%) described the severity as being mild. All but 9 patients (61/70 or 87%) stated that they would definitely or probably undergo a repeat EBUS-TBNA.

CONCLUSIONS: This single-centre UK study confirms that EBUS-TBNA under light conscious sedation is a well-tolerated procedure maintaining the expected diagnostic performance, with patients reporting a high degree of satisfaction with both the test and the information received beforehand.

Original languageEnglish
Pages (from-to)244-50
Number of pages7
JournalRespiration
Volume88
Issue number3
DOIs
Publication statusPublished - 2014

Keywords

  • Anesthetics, Intravenous
  • Bronchoscopy
  • Carcinoma
  • Conscious Sedation
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration
  • Female
  • Fentanyl
  • Humans
  • Lung Neoplasms
  • Lymph Nodes
  • Male
  • Midazolam
  • Middle Aged
  • Neoplasm Staging
  • Patient Satisfaction
  • Prospective Studies
  • Sarcoidosis, Pulmonary
  • Sensitivity and Specificity
  • Tuberculosis, Pulmonary

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