Sedation With Meperidine for Endobronchial Ultrasound-guided Transbronchial Needle Aspiration

Ando, Kenji; Ohkuni, Yoshihiro; Fukazawa, Motoji; Abe, Masaru; Takeshi, Akihiko; Kaneko, Norihiro

doi:10.1097/lbr.0b013e3181f4196d

Cited by 13 publications

(22 citation statements)

References 17 publications

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“…A total of six studies were included in the review. [ 19 20 21 22 23 ] All studies were published in English. Two of them were multicenter studies.…”

Section: Resultsmentioning

confidence: 99%

“…[ 20 22 ] Four studies were conducted in USA,[ 20 21 22 23 ] one study in Turkey,[ 24 ] and one study in Japan. [ 19 ] According to the GRADE Scale,[ 14 ] the level of evidence was moderate in one study[ 23 ] and low in all the remaining studies. [ 19 20 21 22 24 ]…”

Section: Resultsmentioning

confidence: 99%

“…[ 19 ] According to the GRADE Scale,[ 14 ] the level of evidence was moderate in one study[ 23 ] and low in all the remaining studies. [ 19 20 21 22 24 ]…”

Section: Resultsmentioning

confidence: 99%

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The role of sedation in endobronchial ultrasound-guided transbronchial needle aspiration: Systematic review

et al. 2016

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Background:Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure that has become an important tool in diagnosis and staging of mediastinal lymph node (LN) lesions in lung cancer. Adequate sedation is an important part of the procedure since it provides patient's comfort and potentially increases diagnostic yield. We aimed to compare deep sedation (DS) versus moderate sedation (MS) in patients undergoing EBUS-TBNA procedure.Methods:PubMed, EMBASE, MEDLINE, and Cochrane Library were searched for English studies of clinical trials comparing the two different methods of sedations in EBUS-TBNA until December 2015. The overall diagnostic yield, LN size sampling, procedural time, complication, and safety were evaluated.Results:Six studies with 3000 patients which compared two different modalities of sedation in patients performing EBUS-TBNA were included in the study. The overall diagnostic yield of DS method was 52.3%–100% and MS method was 46.1%–85.7%. The overall sensitivity of EBUS-TBNA of DS method was 98.15%–100% as compared with 80%–98.08% in MS method. The overall procedural times were 27.2–50.9 min and 20.6-44.1 min in DS and MS groups, respectively. The numbers of LN sampled were between 1.33–3.20 nodes and 1.36–2.80 nodes in DS and MS groups, respectively. The numbers of passes per LN were 3.21–3.70 passes in DS group as compared to 2.73–3.00 passes in MS group. The mean of LN size was indifferent between two groups. None of the studies included reported serious adverse events.Conclusions:Using MS in EBUS-TBNA has comparable diagnostic yield and safety profile to DS. The decision on the method of sedation for EBUS-TBNA should be individually selected based on operator experience, patient preference, as well as duration of the anticipated procedure.

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“…A total of six studies were included in the review. [ 19 20 21 22 23 ] All studies were published in English. Two of them were multicenter studies.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The role of sedation in endobronchial ultrasound-guided transbronchial needle aspiration: Systematic review

et al. 2016

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“…To our knowledge very few reports have been published evaluating the efficacy of Meperidine and Midazolam used alone or in combination during bronchoscopy and especially during EBUS-TBNA [18,19). At present, there is not a single, well established method of anesthesia universally used during EBUS-TBNA.…”

Section: Discussionmentioning

confidence: 99%

Endobronchial ultrasound-guided transbronchial needle aspiration under conscious sedation with meperidine and midazolam

Agostini¹,

Facciolongo²,

Lusuardi

et al. 2017

Monaldi Arch Chest Dis

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Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) is usually performed under general anesthesia or deep sedation with drugs such as Propofol that, at least in Italy, can be administered only by an anesthesiologist. Aim of the study was to assess conscious sedation feasibility, safety and tolerability using meperidine and midazolam as administered by Pulmonologist and relevant impact on the efficiency of the sampling procedures.All patients undergoing EBUS-TBNA from February 2013 to July 2014 were examined retrospectively. Efficiency using Meperidine and Midazolam during EBUS-TBNA has been assessed: completion of lymphnodal sampling, sampling adequacy, diagnostic yield, cough during endoscopic procedure complications and need for procedure repetition with Anesthesiology assistance. Patient satisfaction and cost/effectiveness were also evaluated. One hundred and thirty-four consecutive patients were considered; 97.7% completed the procedure. In 96.9% of cases the prefixed program of lymph-nodal sampling was accomplished. Sampling adequacy was 92,4%. Diagnostic yield was 55%. In 94.7% of cases cough was absent or did not interfere with EBUS-TBNA. The need to repeat the endoscopic procedure occurred in 6 cases but only in 2 the presence of an Anesthesiologist was required. Patient satisfaction was very high, with 95.9% of subjects reporting they would "definitely return". A 27% cost reduction was calculated. EBUS-TBNA under conscious sedation using Meperidine and Midazolam prescribed and administered by pulmonologist without the Anesthesiologist assistance, revealed to be a safe, well tolerated and cost saving procedure. The efficiency of sampling was good, apart from a relatively low diagnostic yield due to different expertise of operators.

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“…This is probably related to the fact that most studies that assessed the role of sedation in the setting of EBUS-TBNA were observational and retrospective, and they come to different conclusions. 5,[55][56][57][58][59][60] in one of the largest observational trials, for instance, Yarmus et al analyzed a cohort of 309 patients who underwent EBUS-TBNA in two US centers, and concluded that deep sedation improves diagnostic yield and allows to sample more lymph node stations. Several other observational trials tend to contradict these findings and suggest that both diagnostic yield and complication rate are not different in patients submitted to eBUS-TBNa under moderate or deep sedation.…”

Section: Use Of the Scopementioning

confidence: 99%

Competence in endosonographic techniques

Candoli¹,

Ceron²,

Trisolini³

et al. 2019

Panminerva Med

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Endobronchial ultrasound (EBUS) has revolutionized the field of bronchoscopy because it allows to observe peribronchial structures and distal peripheral lung lesions. The use of EBUS was first described by Hurte and Hanrath in 1992. EBUS technology exists in two forms: radial and convex transducer probes. The radial EBUS probe has a 20-MHZ (12-30 MHz available) rotating transducer that can be inserted together with or without a guide sheath through the working channel (2.0-2.8 mm) of a standard flexible bronchoscope. The transducer rotates and produces a 360-degree circular image around the central position of the probe. There are two types of radial EBUS probes: "peripheral" probes, used to identify parenchymal lung lesions, and "central" probes, with balloon sheaths, used for the assessment of airway walls and peribronchial lymph nodes.

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Sedation With Meperidine for Endobronchial Ultrasound-guided Transbronchial Needle Aspiration

Abstract: EBUS-TBNA under the intravenous sedation by MP was as feasible and safe as that under GA. It has a possibility to be one of the effective drugs for sedation during EBUS-TBNA regardless of age, and we should analyze its safety and efficacy in prospective studies henceforth.

Cited by 13 publications

References 17 publications

The role of sedation in endobronchial ultrasound-guided transbronchial needle aspiration: Systematic review

The role of sedation in endobronchial ultrasound-guided transbronchial needle aspiration: Systematic review

Endobronchial ultrasound-guided transbronchial needle aspiration under conscious sedation with meperidine and midazolam

Competence in endosonographic techniques

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