Bronchoscopy Practice in Turkey: A Questionnaire Study

Abstract

Objective: As in the rest of the world, there are differences in attitudes and behaviours among physicians in bronchoscopy applications in our country as well. The aim of this study was to put forward the attitudes and behaviours of bronchoscopists using a questionnaire as the Working Group of Interventional Pulmonology of Turkish Respiratory Society. Methods:The invitation letter prepared individuals for participation in the web-based questionnaire containing 23 questions on the implementation of diagnostic and interventional bronchoscopy; the link to the questionnaire was sent to the e-mail groups of pulmonologists, thoracic surgeons and anesthesia and intensive care specialists. The responses of the physicians participating to the questionnaire were evaluated. The results obtained from the questionnaire were evaluated generally and on the basis of medical branches by statistical analyses. Results:The questionnaire was answered by a total of 146 specialists including 93 pulmonologists, 30 thoracic surgeons and 23 anesthesiologists. In total, 73% of the physicians responding to the questionnaire were working at the University or Training and Research Hospital and 47% of the respondents were conducting more than 100 bronchoscopies per year. Here, 36% of the respondents stated that in the bronchoscopies that they carried out, they did not sedate their patients. On the other hand, the most commonly preferred medication for sedation was midazolam (78%). While 77% of the pulmonologists used nebulised lidocaine as a topical anesthetic, these rates were 12.5% and 8.3% respectively for thoracic surgeons and anaesthesiologists (p<0.001). Also, 38% of pulmonologists were conducting 23% of the diagnostic bronchoscopies under general anesthesia. During bronchoscopy, the pulse oximetry follow-up was found to be 97%, and the supplemental oxygen administration was 87%. Overall, 60% of the pulmonologists thought that at least 100 procedures must be performed under the supervision of a specialist during bronchoscopy training and 40% of them were of the opinion that the number of procedures undertaken must be at least 50. Conclusion:The data of the survey give information about the practice of bronchoscopy in Turkey. It is suggested that the repetition of such questionnaires by increasing the variety of questions and the number of participants will provide an important data source.

Bronkoskopik İşlemlerde Uygulanan Hafif-Orta ve Derin Sedasyonun Hasta ve Bronkoskopist Memnuniyeti Üzerine Etkisi

“…2014 yılında Tozkoparan ve ark. [11] Türkiye'deki göğüs hastalıkları ve göğüs cerrahisi uzmanlarına yaptıkları anket çalışmasında bronkoskopistlerin %36'sının sedasyon uygulamadığı tespit edildi, yaygın olarak sedasyon kullanılmadığı anlaşıldı. Eğitim ve araştırma hastanesi olmamıza rağmen bizim çalışmamızda sedasyon uygulanmayan hasta oranı %26,3 olarak bulundu ki bu oranın yüksek olduğu düşüncesindeyiz.…”

Sedation for bronchoscopy: current practices in Latin America

“…At most of the medical centers surveyed in the present study, especially the private ones, an anesthetist was in charge of sedation for bronchoscopy and its monitoring. In 2012, Tozkoparan et al 5 surveyed bronchoscopists in Turkey. The authors found that 36% of bronchoscopies were performed without sedation, that propofol was used in 21%, and that midazolam was used in 78%.…”

“…We defined sedation as any pharmacological intervention aimed at reducing the level of awareness and anxiety of the patient, to improve the tolerability of the procedure. The questions were based on those employed in previous, similar studies 3 , 5 - 7 and on the experience of the investigators. The questionnaires were completed anonymously and voluntarily between 1 November 2015 and 1 March 2016.…”