Transbronchial Needle Aspiration under the guidance of Endobronchial Ultrasound in Lung Cancer Diagnosis; Retrospective Evaluation of Anesthesia Methods

Abstract

Introduction: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has become a standard procedure in diagnosing and staging lung cancer. Anesthesia management is one of the critical steps in the EBUS-TBNA procedures. We planned to evaluate anesthesia methods for EBUS-TBNA, which was applied for the first time in our hospital, in terms of duration of the procedure and complications. Methods: The records of patients who underwent EBUS-TBNA after ethics committee approval were reviewed retrospectively. We recorded demographic data of the patients, duration of the procedure, anesthesia methods, and complications. Results: A total of 50 patients were given anesthesia for the EBUS-TBNA. General anesthesia was performed in 5 patients and sedation in 45 patients.The duration of anesthesia was 62±17.8 min ingeneral anesthesiaand 50.2±13.1 min in sedated patients (p=0.113). Ketamine/propofol (ketofol) was used in 22 patients, and propofol/fentanyl was used in 23 patients for sedation. The amount of propofol was significantly higher in those using propofol/fentanyl than ketofol (propofol/fentanyl: 342.2±140 mg, ketofol: 166.5±49.9 mg; p=0.002).There was no significant difference in the frequency of postoperative complications. Discussion and Conclusion: The choice of anesthesia method for EBUS procedures should be adjusted according to factors associated with the operator, the patient, and the procedure itself. We think sedation can be used safely in EBUS procedures with good preliminary preparation, intraoperative management, and anesthesiologist-bronchoscopist compatibility.