Endobronchial ultrasound-guided transbronchial needle aspiration under conscious sedation with meperidine and midazolam

https://doi.org/10.4081/monaldi.2017.768

Authors

  • Lorenzo Agostini Azienda Ospedaliera ASMN-Istituto di Ricovero e Cura a Carattere Scientifico, Italy.
  • Nicola Facciolongo | facciolongo.nicola@asmn.re.it Azienda Ospedaliera ASMN-Istituto di Ricovero e Cura a Carattere Scientifico, Italy.
  • Mirco Lusuardi S. Sebastiano Hospital, Respiratory Rehabilitation, Italy.
  • Eleonora Casalini Azienda Ospedaliera ASMN-Istituto di Ricovero e Cura a Carattere Scientifico, Italy.
  • Carla Galeone Azienda Ospedaliera ASMN-Istituto di Ricovero e Cura a Carattere Scientifico, Italy.
  • Luciano Lasagni Azienda Ospedaliera ASMN-Istituto di Ricovero e Cura a Carattere Scientifico, Italy.
  • Luigi Zucchi Azienda Ospedaliera ASMN-Istituto di Ricovero e Cura a Carattere Scientifico, Italy.

Abstract

Endobronchial Ultrasound guided transbronchial needle aspiration (EBUS-TBNA) is usually performed under general anesthesia or deep sedation with drugs such as Propofol that, at least in Italy, can be administered only by an anesthesiologist. Aim of the study was to assess conscious sedation feasibility, safety and tolerability using Meperidine and Midazolam as administered by Pulmonologist and relevant impact on the efficiency of the sampling procedures.
All patients undergoing EBUS-TBNA from February 2013 to July 2014 were examined retrospectively. Efficiency using Meperidine and Midazolam during EBUS-TBNA has been assessed: completion of lymph-nodal sampling, sampling adequacy, diagnostic yield, cough during endoscopic procedure complications and need for procedure repetition with Anesthesiology assistance. Patient satisfaction and cost/effectiveness were also evaluated. One hundred and thirty-four consecutive patients were considered; 97.7% completed the procedure. In 96.9% of cases the prefixed program of lymph-nodal sampling was accomplished. Sampling adequacy was 92,4%. Diagnostic yield was 55%. In 94.7% of cases cough was absent or did not interfere with EBUS-TBNA. The need to repeat the endoscopic procedure occurred in 6 cases but only in 2 the presence of an Anesthesiologist was required. Patient satisfaction was very high, with 95.9% of subjects reporting they would “definitely returnâ€. A 27% cost reduction was calculated. EBUS-TBNA under conscious sedation using Meperidine and Midazolam prescribed and administered by pulmonologist without the Anesthesiologist assistance, revealed to be a safe, well tolerated and cost saving procedure. The efficiency of sampling was good, apart from a relatively low diagnostic yield due to different expertise of operators.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Downloads

Published
2017-07-18
Info
Issue
Section
Pneumology - Original Articles
Supporting Agencies
, , ,
Keywords:
Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA), conscious sedation, midazolam, meperidine.
Statistics
  • Abstract views: 1002

  • PDF: 497
How to Cite
Agostini, Lorenzo, Nicola Facciolongo, Mirco Lusuardi, Eleonora Casalini, Carla Galeone, Luciano Lasagni, and Luigi Zucchi. 2017. “Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration under Conscious Sedation With Meperidine and Midazolam”. Monaldi Archives for Chest Disease 87 (2). https://doi.org/10.4081/monaldi.2017.768.

Similar Articles

You may also start an advanced similarity search for this article.