Objectives: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a new, minimally invasive, bronchoscopic technique used in the evaluation of inthrathoracic lymph nodes.Use of sedation drugs before the procedure differs among centres. There is no standardization about sedation before EBUS-TBNA.We used a policy decision to shift from use of propofol with midazolam vs midazolam alone in a large tertiary hospital to evaluate the diagnostic yield and safety of EBUS-TBNA procedure.
Methods: Files of all the patients who were performed EBUS-TBNA between the dates of September 2010 and May 2014 were surveyed. All the EBUS-TBNA cases were performed under sedation of propofol and midazolam with an accompanying anesthesiologist in the beginning, however, sedation is applied with midazolam without an accompanying anesthesiologist after April 2013 due to changes in sedation policy. The diagnostic yield and complication rates were compared by chi-squared analysis between two groups.
Results: The files of 340 EBUS-TBNA performed patients were evaluated. Of the patients 274 eligible patients were analysed. 152 patients who fulfilled the inclusion criteria were analysed in propofol-midazolam (P) sedated group and 122 patients were analysed in midazolam (M) group. There is no statistically significant difference between two different sedated groups in terms of age and gender. Diagnostic value was detected as 77.6% in P group and 85.7% in M group and the difference was not statistically significant. No difference between complication rates of both groups was observed.
Conclusion: Both sedation-types for performing EBUS-TBNA showed similar diagnostic value and complication rates in our study. Propofol with midazolam application requires with an accompanying anaesthesiologist, therefore, it increases cost. EBUS-TBNA procedures had been performed in safe with no decrease in diagnostic yield under moderate sedation.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/crj.12442 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The nociceptive withdrawal reflex during spinal analgesia in pigs undergoing veno-arterial extracorporeal membrane oxygenation: a prospective observational study.
Front Vet Sci
December 2024
Experimental Surgery Facility, Experimental Animal Center, Faculty of Medicine, University of Bern, Bern, Switzerland.
Introduction: Use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is still in the focus of research, in which pigs are commonly involved. During VA-ECMO, cardiovascular parameters are artificially manipulated and therefore not reliable indicators of nociception. Nociceptive withdrawal reflex (NWR) thresholds can be a suitable alternative in such a context.
View Article and Find Full Text PDFEfficacy of propofol and midazolam combination in managing refractory epileptic encephalopathy with spike-wave activation in sleep.
Epilepsy Behav Rep
March 2025
Department of Neurology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China.
We presented a 7-year-old boy with refractory Epileptic Encephalopathy with Spike-and-Wave Activation in Sleep (EE-SWAS) successfully managed with a combination of propofol and midazolam. His seizures began at age 2, initially controlled by multiple antiseizure medications (ASMs) for almost three years. At age 5, seizures recurred with electroencephalography (EEG) showing electrical status epilepticus in sleep (ESES) and a spike-wave index (SWI) of 85 %.
View Article and Find Full Text PDFProcedural sedation in the emergency department by Italian emergency physicians: results of the SEED SIMEU registry.
Eur J Emerg Med
December 2024
Emergency Department, Azienda Sanitaria Locale Torino 3 (ASL TO3) Ospedale E. Agnelli, Pinerolo.
Background And Importance: Effective and safe procedural sedation is pivotal for the quality of care in the emergency department (ED).
Objectives: The aim of this work is to evaluate the feasibility, effectiveness, and safety procedural sedation performed by emergency physicians in the ED setting in Italy.
Design/setting And Participants/intervention: Following a specific training of the staff and with the adoption of a standardized protocol, a registry of procedural sedations performed on adult patients in 10 Italian EDs was compiled from 2019 to 2022; the following basic data were recorded: demographic and clinical information, procedure's indication, administered drugs, predefined, and actual sedation level.
How to NAPS: A Discussion of the Safety and Implementation of a Nurse Administered Propofol Sedation (NAPS) Program.
Gastroenterol Nurs
December 2024
About the authors: Frances R. Roe, MSN, RN, CNOR, Clinical Practice Support, Legacy Health, Portland, Oregon.
Anesthesia shortages impact patient accessibility to endoscopy procedures. The administration of midazolam and fentanyl by a nurse is an accepted practice of delivering procedural sedation, though there is still controversy around the safety of a nurse administered propofol sedation (NAPS) program. Applicable professional organizations have provided statements supporting NAPS by a trained and competent nurse under the direction of an appropriately credentialed proceduralist.
View Article and Find Full Text PDFThe Efficacy and Safety Profile of Balanced Propofol Sedation for Bronchoscopy.
Ther Clin Risk Manag
December 2024
Department of Anesthesiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People's Republic of China.
Purpose: We conducted a prospective, real-world study to evaluate the efficacy and safety of balanced propofol sedation (BPS) in bronchoscopy and identify an advantageous sedation regimen for such procedures.
Patients And Methods: The participants were placed in four groups based on their sedation regimen (exposure factor): the M-S group (midazolam + sufentanil for traditional sedation), R-S group (remimazolam + sufentanil for traditional sedation), M-S-P group (midazolam + sufentanil + propofol for BPS), and R-S-P group (remimazolam + sufentanil + propofol for BPS). The primary outcomes included satisfaction metrics (satisfaction of the patients, endoscopic physicians, and nurses) and follow-up questionnaires.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!