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. 2018 Nov 8;7(11):421.
doi: 10.3390/jcm7110421.

Endobronchial Ultrasound under Moderate Sedation versus General Anesthesia

Maria Gabriela O Fernandes  1   2 , Vanessa F Santos  3 , Natália Martins  4   5   6 , Maria C Sucena  7 , Madalena M Passos  8 , Maria Manuel Marques  9 , Adriana M Magalhães  10 , António Bugalho  11   12
Affiliations

Endobronchial Ultrasound under Moderate Sedation versus General Anesthesia

Maria Gabriela O Fernandes et al. J Clin Med. .

Abstract

Background: Different anesthetic protocols may influence endobronchial ultrasound-guided needle aspiration (EBUS-TBNA) outcomes, patient comfort, and even safety. In this study, two anesthesia techniques were assessed and compared for EBUS-TBNA.

Methods: A prospective, multicenter study was carried out. Patients were allocated to Group 1 (general anesthesia with neuromuscular blockade and controlled ventilation) and Group 2 (intravenous sedation). EBUS-TBNA accuracy was the primary outcome. Safety, patient comfort and satisfaction, and operators' difficulties were defined as secondary outcomes.

Results: Of the 115 patients enrolled (Group 1 = 59, Group 2 = 56), EBUS-TBNA was performed for hilar or mediastinal lesion diagnosis and lung cancer staging in, respectively, 77 (67%) and 38 (33%) patients. The numbers of lymph nodes stations (1.8 ± 1.0 vs. 1.7 ± 1.0, p = 0.472) and punctures per station (6.9 ± 3.1 vs. 6.0 ± 2.5, p = 0.084) were similar between groups. Adequate samples were obtained from 109 patients (97.3%) with similar diagnostic accuracy. Procedure duration was not significantly different (p = 0.348). Hemodynamic parameters and systolic and diastolic blood pressures were higher in Group 1 at the beginning and at the end of the procedure. Adverse events were equally distributed, and no significant differences were found regarding patient satisfaction and bronchoscopist/anesthesiologist difficulties.

Conclusions: The type of anesthesia used did not influence EBUS-TBNA outcomes. EBUS-TBNA performed under sedation or general anesthesia did not affect the diagnostic yield, complication rate, and patients' comfort and satisfaction.

Keywords: diagnosis; endobronchial ultrasound; general anesthesia; sedation; staging.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study protocol. IGA, intravenous general anesthesia; NMB, neuromuscular blockade; IVS, intravenous sedation; EBUS-TBNA, endobronchial ultrasound-guided needle aspiration; HADS-A, Hospital Anxiety and Depression Scale.
See this image and copyright information in PMC

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