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Interventional Pulmonology
Respiration 2014;88:244–250
DOI: 10.1159/000363063
Endobronchial Ultrasound-Guided
Transbronchial Needle Aspiration: Patient
Satisfaction under Light Conscious Sedation
Abiramy Jeyabalan Andrew R.L. Medford
North Bristol Lung Centre, North Bristol NHS Trust, Southmead Hospital, Bristol, UK
midazolam. The sensitivity of EBUS-TBNA for the cancer stag-
ing, cancer diagnosis and granulomatous disease cohorts
was 90.0, 94.1 and 87.5%, respectively. The most commonly
reported symptom was a cough in 65 (93%) patients. Of
these patients, 46 (71%) described the severity as being mild.
All but 9 patients (61/70 or 87%) stated that they would def-
initely or probably undergo a repeat EBUS-TBNA. Conclu-
sions: This single-centre UK study confirms that EBUS-TBNA
under light conscious sedation is a well-tolerated procedure
maintaining the expected diagnostic performance, with pa-
tients reporting a high degree of satisfaction with both the
test and the information received beforehand.
© 2014 S. Karger AG, Basel
Background
Endobronchial ultrasound-guided transbronchial
needle aspiration (EBUS-TBNA) is a mediastinal sam-
pling technique recommended by the National Institute
of Clinical Excellence [1] for the staging and diagnosis of
non-small-cell lung cancer. It is also used to diagnose un-
explained accessible mediastinal adenopathy and lesions
[2]. The procedure can be carried out under general an-
aesthesia with the use of airway adjuncts but is common-
ly performed under light conscious sedation in UK cen-
tres in an endoscopy room with a short-recovery area.
Key Words
Patient satisfaction · Endobronchial ultrasound ·
Transbronchial needle aspiration · Conscious sedation
Abstract
Background: Endobronchial ultrasound-guided transbron-
chial needle aspiration (EBUS-TBNA) is an increasingly used
mediastinal sampling technique. Many centres use con-
scious sedation in an ambulatory setting to optimise the
flow of patients, save costs and shorten recovery time. The
only EBUS-TBNA patient satisfaction study published so far
used deep conscious sedation with propofol. To our knowl-
edge, ours is the largest prospective study evaluating the
experience of patients undergoing EBUS-TBNA using light
conscious sedation without propofol. Objectives: To evalu-
ate the patient tolerability of EBUS-TBNA under mild con-
scious sedation. Methods: Eighty-two consecutive patients
between January 2011 and November 2011 requiring EBUS-
TBNA under light conscious sedation for either mediastinal
staging of lung cancer or the diagnosis of suspected medi-
astinal disease due to malignancy or granulomatous disease
were invited to complete a questionnaire after the interven-
tion. The collection of data included the diagnostic yield, the
number and size of nodes sampled and the dose of sedative
medication administered. Results: The average dose of sed-
ative agents administered was 59.4 μg fentanyl and 3.2 mg
Received: October 7, 2013
Accepted after revision: April 22, 2014
Published online: August 21, 2014
Dr. Andrew R.L. Medford
North Bristol Lung Centre and University of Bristol
Southmead Hospital, Westbury-on-Trym
Bristol BS10 5NB (UK)
E-Mail andrewmedford @ hotmail.com
© 2014 S. Karger AG, Basel
0025–7931/14/0883–0244$39.50/0
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