Identification of factors during bronchoscopy that affect patient reluctance to undergo repeat examination: Questionnaire analysis after initial bronchoscopy

Fujimoto, Kazushi; Ishiwata, Tsukasa; Kasai, Hajime; Terada, Jiro; Shionoya, Yu; Ikari, Jun; Kawata, Naoko; Tada, Yuji; Tsushima, Kenji

doi:10.1371/journal.pone.0208495

Cited by 11 publications

(18 citation statements)

References 12 publications

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“…In addition to patient satisfaction, operator satisfaction is equally important. [18] In our study, VAS scores for coughing and operator discomfort were better in the FM group than in the LA group, as recorded by bronchoscopists. This is in agreement with the results of a study by Daisuke et al [19] Some studies suggest that the advantage of opioids compared to benzodiazepines is the suppression of cough and pain.…”

Section: Discussionsupporting

confidence: 49%

Safety and efficacy of fentanyl combined with midazolam in bronchoscopy under bispectral index-guided conscious sedation

Zhang

Zhou

Xiong

et al. 2020

Preprint

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Background: Sedation combined with local anesthesia during bronchoscopy is widely accepted in America and Europe, and receiving great attention in China. This study aimed to investigate the safety and efficacy of fentanyl combined with midazolam for bispectral index (BIS) titrated conscious sedation during bronchoscopy in the Chinese population. Methods: Data from 436 patients who underwent bronchoscopy under local anesthesia (LA group) or BIS-guided conscious sedation combined with local anesthesia (FM group) were retrospectively analyzed. The analysis included vital signs, adverse events recorded during the procedure, and questionnaire information, such as patient tolerance and satisfaction, operator satisfaction, and the cough score noted after the procedure. Results: A total of 225 patients in the LA group, and 211 in the FM group were enrolled in the study. The blood pressure and oxygen saturation were significantly higher in the LA group than in the FM group during bronchoscopy (P<0.001). The heart rate was significantly faster in the LA group at T3max, T3min and T4 than in the FM group. The incidence of hypoxia and bradycardia was higher in the FM group than in the LA group, whereas incidence of hypertension and tachycardia was lower. Patient satisfaction and tolerance of the procedure were significantly better in the FM group. visual analog scale (VAS) scores for cough and operator satisfaction were better in the FM group than in the LA group. Sub-group analysis (inspection, biopsy and transbronchial biopsy guided by radial endobronchial ultrasound (rEBUS-TBB)) indicated that the vital signs, adverse event(hypoxia) and patient satisfaction of the two groups were similar to the previous results. However, the VAS scores for operators’ satisfaction was no significant difference between the two groups in patients undergoing inspection. Conclusions: The conscious sedation regimen of fentanyl combined with midazolam monitored by BIS during bronchoscopy is safe and effective. Although the incidence of hypoxia and bradycardia was higher, the patient’s tolerance and physician’s satisfaction were significantly improved, especially during lengthy procedures, such as intrabronchial biopsy and transbronchial biopsy guided by radial endobronchial ultrasound. Trial registration: The study was approved by the ethics committee of Changzhou first people's Hospital (2019-020). Key words: bronchoscopy, bispectral index, conscious sedation, midazolam, fentanyl.

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Section: Discussionsupporting

confidence: 49%

Safety and efficacy of fentanyl combined with midazolam in bronchoscopy under bispectral index-guided conscious sedation

Zhang

Zhou

Xiong

et al. 2020

Preprint

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“…The previous studies’ results revealed that patients who had had a bronchoscopy in the past were less fearful and anxious than the first time [ 5 , 58 ]. The current study supports this observation.…”

Section: Discussionmentioning

confidence: 99%

Association between Anxiety, Depressive Symptoms, and Quality of Life in Patients Undergoing Diagnostic Flexible Video Bronchoscopy

Brajer-Luftmann

Mardas

Stelmach-Mardas

et al. 2021

IJERPH

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Bronchoscopy is one of the basic invasive procedures in pulmonology accompanied by patients’ anxiety. This study aimed to find an association between predictors of state anxiety/depression and patient’s quality of life (QOL) with pulmonary symptoms undergoing diagnostic flexible video bronchoscopy (FVB). A total of 125 adult patients before FVB were included in a prospective observational study. The quality of life (QOL) was assessed by WHOQOL-BREF questionnaire, the depression possibility by the Beck’s Depression Inventory-II (BDI-II), and the anxiety level by Spielberger’s State-Trait Anxiety Inventory (STAI-S; STAI-T). Results show that the older patients and patients with more comorbidities showed a significantly higher anxiety level. The previous FVB under deep sedation significantly reduced state anxiety. A significantly positive association was found between the STAI score and total BDI-II score. More severe symptoms of anxiety were especially related to lower QOL (physical health, psychological and environmental domains) in patients. Statistically higher trait anxiety in lower social QOL domain scores was observed. Our findings show that high state and trait anxiety were associated with higher depression scores and lower quality of life in the elderly. It seems that the elderly and patients at risk of depression development require more attention in the clinical setting to minimize the anxiety accompanying the bronchoscopy.

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“…Regarding discomfort during bronchoscopy, previous reports suggested that female sex, unexpected pain [ 7 ], severe anxiety before bronchoscopy, bronchoscopist’s experience [ 3 ], nasal insertion, and examination time [ 4 ] affect patient discomfort. Among the predictive factors that were significant in our multivariate analysis, less-experienced bronchoscopists had already been published in a previous report [ 3 ], but younger age and cough severity have not been widely reported.…”

Section: Discussionmentioning

confidence: 99%

“…Among the predictive factors that were significant in our multivariate analysis, less-experienced bronchoscopists had already been published in a previous report [ 3 ], but younger age and cough severity have not been widely reported. Previous studies enrolled relative younger patients (i.e., aged 64.7 ± 12.4 years [mean ± standard deviation] [ 7 ], 59.9 ± 15.1 years [ 3 ], and 56.5 ± 13.7 years [ 4 ]) compared to those enrolled in ours (67.83 ± 13.44 years), which might emphasize that younger age itself can be a predictive factor for discomfort, especially in an aging society like that of Japan. Interestingly, this study demonstrated that “cough severity” was another predictive factor for discomfort, but the relationship between cough and patient discomfort has been scarcely reported.…”

Section: Discussionmentioning

confidence: 99%

Novel predictive factors for patient discomfort and severe cough during bronchoscopy: A prospective questionnaire analysis

et al. 2020

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During bronchoscopy, discomfort is mainly caused by an unavoidable cough; however, there are no reports of any predictive factors for strong cough during bronchoscopy identified before the procedure. To clarify the factors underlying the discomfort status and predictive factors for strong cough during bronchoscopy, we prospectively evaluated patients who underwent bronchoscopy at Kyorin University Hospital between March 2018 and July 2019. Before and after bronchoscopy, the enrolled patients answered a questionnaire regarding the procedure. At the same time, bronchoscopists evaluated cough severity using a fourgrade cough scale. We evaluated patient characteristics and predictive factors associated with bronchoscopy from the perspective of discomfort and strong cough. A total of 172 patients were ultimately enrolled in this study. On multivariate logistic regression analysis, comparison of the subjective data between the discomfort and comfort groups revealed that factors that were more common in the former group were younger age (OR = 0.96, p = 0.002), less experienced bronchoscopist (OR = 2.08, p = 0.047), and elevation of cough score per 1 point (OR = 1.69, p < 0.001). Furthermore, the predictive factors for strong cough prior to performing bronchoscopy were female sex (OR = 2.57, p = 0.009), EBUS-TBNA (OR = 2.95, p = 0.004), and prolonged examination time of more than 36 min (OR = 2.32, p = 0.022). Regarding patients' discomfort, younger age, less experienced bronchoscopist, and the elevation of cough score per 1 point were important factors for discomfort in bronchoscopy. On the other hand, female sex, EBUS-TBNA, and prolonged examination time were crucial factors for strong cough.

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Identification of factors during bronchoscopy that affect patient reluctance to undergo repeat examination: Questionnaire analysis after initial bronchoscopy

Cited by 11 publications

References 12 publications

Safety and efficacy of fentanyl combined with midazolam in bronchoscopy under bispectral index-guided conscious sedation

Safety and efficacy of fentanyl combined with midazolam in bronchoscopy under bispectral index-guided conscious sedation

Association between Anxiety, Depressive Symptoms, and Quality of Life in Patients Undergoing Diagnostic Flexible Video Bronchoscopy

Novel predictive factors for patient discomfort and severe cough during bronchoscopy: A prospective questionnaire analysis

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