Tolerance and Safety of 5 Models of Sedation During Endobronchial Ultrasound

Viedma, Enrique Cases; García, Felipe Andreo; Aldeyturriaga, Javier Flandes; Mezquida, Juan Pablo Reig; Gómez, Andrés Briones; Caral, Pere Vila; Basozabal, Iker Fernández-Navamuel; Clemente, Carmen Centeno; Campo, Felipe; Martínez, Estefanía Sánchez; Moret, Francisca Sanchís; Pérez, Josefina Manjón; Yepes, Marina Sánchez

doi:10.1016/j.arbr.2015.11.004

Cited by 6 publications

(4 citation statements)

References 19 publications

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“…Endobronchial ultrasonography-guided transbronchial needle aspiration (EBUS-TBNA) is a technique that provides imaging and sampling of structures adjacent to the bronchial wall while bronchoscopy is being performed and is an effective method for diagnosing and staging lung diseases [1][2][3]. Sedoanalgesia is essential for patient comfort and procedure quality during endobronchial ultrasound (EBUS).…”

Section: Introductionmentioning

confidence: 99%

The Effects of Magnesium Sulphate on Integrated Pulmonary Index Scores and Propofol Consumption During Endobronchial Ultrasonography: A Retrospective Study

Adıgüzel,

Akyurt,

Gullu Arslan

et al. 2023

Cureus

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Our aim in this study was to investigate the effect of inhaled and intravenous (iv) magnesium (Mg) use on Integrated Pulmonary Index (IPI) score and propofol consumption in patients undergoing endobronchial ultrasonography (EBUS) procedure under sedoanalgesia. Materials and methodsAfter obtaining the approval of the local ethics committee, the files of 96 patients aged 18-75 who underwent EBUS were reviewed retrospectively. Patients using Mg were classified as the M group, and patients not using Mg were classified as the control (C) group. IPI values, amount of propofol consumed, and intubation scores of group M and group C were evaluated. ResultsWhen the intubation score values at the time of the bronchoscope passing through the vocal cords (assessment of vocal cord movement, cough reflex, and leg movement) during the EBUS procedure were compared, the intubation conditions were found to be significantly better in the M group than in the C group (p<0.05). Group M had less cough reflex than group C (p<0.05). IPI scores were significantly higher in the M group than in the C group at the 10th and 15th minutes (p<0.05). Total propofol consumption was found to be significantly lower in the M group (254.61±82.80 mg) than in the C group (321.25±90.04 mg) (p<0.05). ConclusionAccording to our results, the use of intravenous and inhaler Mg in addition to propofol sedation during the EBUS procedure may improve the respiratory parameters and can also significantly reduce the propofol dose.

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Section: Introductionmentioning

confidence: 99%

The Effects of Magnesium Sulphate on Integrated Pulmonary Index Scores and Propofol Consumption During Endobronchial Ultrasonography: A Retrospective Study

Adıgüzel,

Akyurt,

Gullu Arslan

et al. 2023

Cureus

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“…It has been reported previously in the literature that minimal, moderate, and deep sedation are safe and efficacious. 15 – 19 In both retrospective and prospective studies of sedation techniques, continuous propofol infusion, midazolam, meperidine, ketamine-midazolam, ketamine-propofol, propofolmidazolam, and midazolam-fentanyl have all shown similar effectiveness. 15 , 20 – 23 However, Cases-Viedma et al demonstrated fewer respiratory and non-respiratory complications when combined midazolam-propofol and combined midazolam-fentanyl were used for patient sedation.…”

Section: Introductionmentioning

confidence: 99%

“… 15 – 19 In both retrospective and prospective studies of sedation techniques, continuous propofol infusion, midazolam, meperidine, ketamine-midazolam, ketamine-propofol, propofolmidazolam, and midazolam-fentanyl have all shown similar effectiveness. 15 , 20 – 23 However, Cases-Viedma et al demonstrated fewer respiratory and non-respiratory complications when combined midazolam-propofol and combined midazolam-fentanyl were used for patient sedation. 15 Additionally, bispectral index monitoring has been shown to decrease the number of adverse events, including hypoxia and hypotension, when administering sedation for EBUS-TBNA.…”

Section: Introductionmentioning

confidence: 99%

“… 15 , 20 – 23 However, Cases-Viedma et al demonstrated fewer respiratory and non-respiratory complications when combined midazolam-propofol and combined midazolam-fentanyl were used for patient sedation. 15 Additionally, bispectral index monitoring has been shown to decrease the number of adverse events, including hypoxia and hypotension, when administering sedation for EBUS-TBNA. 24 …”

Section: Introductionmentioning

confidence: 99%

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A Retrospective Analysis of Respiratory Complications under General Anesthesia during EBUS-TBNA

Bergbower¹,

Hong²,

Gibbons³

et al. 2022

Journal of Community Hospital Internal Medicine Perspectives

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Background EBUS-TBNA is an established technique for diagnostically sampling intrathoracic masses and lymph nodes. While the procedure is commonly conducted under general anesthesia (GA), little is known regarding the association between anesthetic management and perioperative respiratory complications. Here, we aim to evaluate this association among patients presenting for EBUS-TBNA. Methods 586 patients receiving GA for EBUS-TBNA between 2012 and 2018 were retrospectively evaluated. The primary endpoint was the occurrence of perioperative respiratory complications and the secondary endpoint was procedure end to OR exit time (minutes). Respiratory complications were defined as episodes of severe (SpO 2 <85%) or prolonged (SpO 2 <90% for >5 min) hypoxemia, bronchospasm, and postoperative ventilation that could not be directly attributed to procedural invasiveness. Results Among all patients, 79 (13.5%) had respiratory complications. Four patient characteristics were associated with respiratory complications: home oxygen use (OR 2.39; 95% CI 1.26–4.45; P = 0.007), pre-existing respiratory disease (OR 2.01; CI 1.21–3.29; P = 0.005), ASA class (P = 0.03), and albuterol administration intra-operatively (OR 2.22; CI 1.23–3.92; P = 0.007). No anesthetic factors were found to be statistically significant. Procedures with respiratory complications had a longer duration (mean time 88.7 min vs. 111.8 min; P = 0.00009), prolonged time to extubation (mean time 11.9 min vs. 14.2 min; P = 0.039), and stayed in the room longer after extubation (mean time 18.4 min vs. 23.1 min; P = 0.0016). When comparing types of GA, there were no significant differences between volatile anesthetics versus TIVA (12.7% vs. 14.6%, P = 0.54). Conclusions Pre-existing patient characteristics, as opposed to anesthetic factors, are associated with respiratory complications during EBUS-TBNA.

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High-flow Nasal Oxygen Versus Standard Oxygen During Flexible Bronchoscopy in Lung Transplant Patients

Ben‐Menachem

McKenzie²,

O'Sullivan³

et al. 2020

Journal of Bronchology &Amp; Interventional Pulmonology

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Background: Diagnostic and interventional flexible bronchoscopy (FB) is increasingly utilized in complex and high-risk patients. Patients are often sedated for comfort and procedure facilitation and hypoxia is commonly observed in this setting. We hypothesized that high-flow nasal oxygen (HFNO) would reduce the incidence of patients experiencing oxygen desaturation. Methods: In this randomized controlled trial, postlung transplant patients booked for FB with transbronchial lung biopsy were assigned to either HFNO or low-flow nasal oxygen (LFNO). The patient and bronchoscopist were blinded to group allocation. The primary endpoint was the proportion of patients experiencing mild desaturation [peripheral oxygen saturation (SpO2)<94%]. Secondary endpoints included desaturation (SpO2<90%), the number of airway interventions required and procedure interruptions, the duration of oxygen desaturation and patient, bronchoscopist and anesthesiologist satisfaction scores. Results: The trial analyzed data from 76 patients (LFNO, n=39; HFNO, n=37). HFNO reduced the proportion of patients experiencing SpO2<94% (43.2% vs. 89.7%, P<0.001) and SpO2<90% (16.2% vs. 69.2%, P<0.001). The FB was interrupted 11 times in 9 patients in the LFNO group, whereas there were no interruptions in the HFNO group. There were no differences in patient and bronchoscopist satisfaction scores between groups, anesthesiologists had higher satisfaction scores when using HFNO (P<0.001). Conclusion: Hypoxia occurred less commonly in postlung transplant patients receiving HFNO during FB. Further studies are warranted in other high-risk populations undergoing longer duration FB.

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Tolerance and Safety of 5 Models of Sedation During Endobronchial Ultrasound

Cited by 6 publications

References 19 publications

The Effects of Magnesium Sulphate on Integrated Pulmonary Index Scores and Propofol Consumption During Endobronchial Ultrasonography: A Retrospective Study

The Effects of Magnesium Sulphate on Integrated Pulmonary Index Scores and Propofol Consumption During Endobronchial Ultrasonography: A Retrospective Study

A Retrospective Analysis of Respiratory Complications under General Anesthesia during EBUS-TBNA

High-flow Nasal Oxygen Versus Standard Oxygen During Flexible Bronchoscopy in Lung Transplant Patients

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