The Cricothyroid versus Spray-As-You-Go Method for Topical Anesthesia during Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA)

Mittal, Saurabh; Gupta, Nishkarsh; Iyer, Hariharan; Biswal, Shiba Kalyan; Tiwari, Pawan; Hadda, Vijay; Mohan, Anant; Guleria, Randeep; Madan, Karan

doi:10.4103/lungindia.lungindia_801_20

Cited by 3 publications

(1 citation statement)

References 13 publications

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“…As a highly selective α2 receptor agonist, dexmedetomidine can resist and tolerate histamine ideally. Compared with propofol, dexmedetomidine can inhibit bronchoconstriction risk related to histamine release, regulate and reduce airway reactivity during bronchoscopy, and have better sedative and analgesic effects [18][19]. During bronchoscopy, the dose of dexmedetomidine is small, so it has little effect on the respiratory function of the examined patients.…”

Section: Discussionmentioning

confidence: 99%

Effect Analysis of Dexmedetomidine Combined With Propofol in Bronchoscopy

Zhang,

Zhao,

et al. 2023

IJCEMR

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Objective: To study and analyze the anesthetic effect of dexmedetomidine combined with propofol during bronchoscopy. Methods: 60 patients who received bronchoscopy in our hospital from September 2020 to October 2022 were selected and divided into study group and control group by random number table method, with 30 patients in each group. In bronchoscopy, other medical procedures except anesthesia were consistent between the two groups. The control group was given propofol anesthesia, while the study group was given dexmedetomidine combined with propofol anesthesia. The general treatment, stress indexes before and after bronchoscopy, incidence of adverse reactions and so on were evaluated and compared between the two groups. Results: There was no statistical difference in the total time spent in bronchoscopy between the two groups (P > 0.05). Anesthesia induction time and recovery time in the study group were shorter than those in the control group, and the difference was statistically significant (P < 0.05). After bronchoscopy, NE and Cor were increased in both groups, and the difference was statistically significant compared with before treatment (P < 0.05). NE and Cor levels in the study group were lower than those in the control group, and the difference was statistically significant (P < 0.05). The incidence of adverse reactions in the study group was lower than that in the control group, and the difference was statistically significant (P < 0.05). Conclusion: In bronchoscopy, dexmedetomidine combined with propofol can shorten the induction time and recovery time of anesthesia, improve the stress response of patients, and enhance the safety of examination.

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Section: Discussionmentioning

confidence: 99%

Effect Analysis of Dexmedetomidine Combined With Propofol in Bronchoscopy

Zhang,

Zhao,

et al. 2023

IJCEMR

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A Survey of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA) practices in India

et al. 2022

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Background: There is a lack of data on the prevalent practices of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in India. Aim: To study the current practices of EBUS-TBNA in India. Methods: This survey was an online questionnaire designed on the Google forms interface. The survey included various questions related to demographics, sedation, analgesia and anesthesia, technical aspects, and infection control related to the procedure of EBUS-TBNA. Results: Data from 134 respondents (mean age: 42.2 years) were analyzed. Most (97.8%) were pulmonologists or physicians, and a majority (94.8%) practicing in either a private multi-specialty setting or medical college. 40.3% had received procedure training at a formal training program. Mild/moderate sedation was the most common strategy (70.1%). Midazolam (76.7%), Fentanyl (76.0%), followed by propofol (46.5%), were the most frequent drugs, and 82.8% preferred combination sedation. 26.1% used cricothyroid lignocaine injection, and the use of 1% or 2% lignocaine for spray-as-you-go administration was similar. The oral route was preferred, while the laryngeal mask airway was the most common airway conduit under general anesthesia. Suspected granulomatous mediastinal lymphadenopathy (TB/sarcoidosis) (67.2%), followed by lung cancer (32.8%), were the most common indications of EBUS-TBNA. 81.3% performed EBUS-TBNA for lung cancer staging. 21 G needle was preferred (64.9%), and vacuum suction was common (80.6%). 55.2% routinely performed ROSE. Alcohol fixed glass slide smears were the most common method (93.1%) for cytological preparation. 49.3% also performed EUS-B-FNA. 76.9% routinely obtained endo bronchial biopsy and transbronchial lung biopsy in patients with suspected sarcoidosis. Elastography was infrequently used. Nearly three-fourths (77.6%) reused EBUS needles. Conclusion: There is practice variability in the multiple aspects related technical performance of EBUS-TBNA. Evidence-based guidelines addressing the multiple technical aspects are required to standardize the practice of EBUS-TBNA.

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Guidelines for endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA): Joint Indian Chest Society (ICS)/Indian Association for Bronchology (IAB) recommendations

Mohan,

Madan,

Hadda

et al. 2023

Lung India

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Over the past decade, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has become an indispensable tool in the diagnostic armamentarium of the pulmonologist. As the expertise with EBUS-TBNA has evolved and several innovations have occurred, the indications for its use have expanded. However, several aspects of EBUS-TBNA are still not standardized. Hence, evidence-based guidelines are needed to optimize the diagnostic yield and safety of EBUS-TBNA. For this purpose, a working group of experts from India was constituted. A detailed and systematic search was performed to extract relevant literature pertaining to various aspects of EBUS-TBNA. The modified GRADE system was used for evaluating the level of evidence and assigning the strength of recommendations. The final recommendations were framed with the consensus of the working group after several rounds of online discussions and a two-day in-person meeting. These guidelines provide evidence-based recommendations encompassing indications of EBUS-TBNA, pre-procedure evaluation, sedation and anesthesia, technical and procedural aspects, sample processing, EBUS-TBNA in special situations, and training for EBUS-TBNA.

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The Cricothyroid versus Spray-As-You-Go Method for Topical Anesthesia during Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA)

Cited by 3 publications

References 13 publications

Effect Analysis of Dexmedetomidine Combined With Propofol in Bronchoscopy

Effect Analysis of Dexmedetomidine Combined With Propofol in Bronchoscopy

A Survey of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA) practices in India

Guidelines for endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA): Joint Indian Chest Society (ICS)/Indian Association for Bronchology (IAB) recommendations

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