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Monaldi Archives for Chest Disease
Article . 2018 . Peer-reviewed
License: CC BY NC
Data sources: Crossref
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Monaldi Archives for Chest Disease
Article
License: CC BY NC
Data sources: UnpayWall
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Deep sedation versus minimal sedation during endobronchial ultrasound transbronchial needle aspiration

Authors: Conte SC; Spagnol G; Confalonieri M; Brizi B.;

Deep sedation versus minimal sedation during endobronchial ultrasound transbronchial needle aspiration

Abstract

The sedation plays an important role in the endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) procedure. The sedation can be Minimal (anxiolysis), Moderate (conscious sedation) or Deep. The ACCP guidelines suggest that moderate or deep sedation (DS) is an acceptable approach. In fact, several studies compare moderate versus deep sedation, but no study has been carried out to compare deep sedation versus minimal. We carried out a retrospective study to compare the Deep versus Minimal sedation (MiS) in patients undergoing EBUS-TBNA. The primary end point was the diagnostic accuracy. The secondary end points were adequacy and sensitivity. We evaluated the LN size sampling, procedural time, complications and patient tolerance. Thirty-six patients underwent EBUS-TBNA, 16 under DS and 20 under MiS. The overall diagnostic accuracy for correct diagnosis was 92.9% in DS group and 94.1% in MiS group (p=0.554). Sample adequacy, defined as the percentage of patients with a specific diagnosis by EBUS-TBNA, was 87.5% (14 of 16) and 85% (17 of 20) for the DS group and MiS group, respectively, (p=0.788); the sensitivity was 92.9% in the DS group (95% CI, 73-100%) and 92.9% in the MiS group (95% CI, 77-100%) (p=0.463). There were no major complications in either group. Minor complications were 4 in MiS and 1 in DS (p=0.355). The patients in the MiS group recalled the procedure more often compared to the other group (p=0.041). The majority of the patients would agree to undergo the same procedure again in the future in both groups (p=0.766). In our experience EBUS-TBNA performed under MiS has comparable accuracy, adequacy, sensitivity, complications and patient satisfaction to DS, even if the sample was small. Future prospective multicenter studies are needed to confirm our results.

Country
Italy
Related Organizations
Keywords

Adult, Male, bronchoscopy, Lung Neoplasms, Midazolam, Lymphadenopathy, Adenocarcinoma, bronchoscopy; sedation, Endosonography, Bronchoscopy, Humans, Carcinoma, Small Cell, Endoscopic Ultrasound-Guided Fine Needle Aspiration, Aged, Aged, 80 and over, R, Fentanyl, sedation, Anti-Anxiety Agents, deep sedation, minimal sedation, Carcinoma, Squamous Cell, patient satisfaction., Medicine, diagnostic accuracy, Female, Deep Sedation, Anesthetics, Intravenous, Endobronchial ultrasound, Adjuvants, Anesthesia

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    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 10%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Average
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
8
Top 10%
Top 10%
Average
Green
Published in a Diamond OA journal