Pulmonary Procedures |

Tolerance of the Endobronchial Ultrasound (EBUS) Using Five Different Sedation Models FREE TO VIEW

José Ferrando, MBBS; Iker Fernández-Navamuel, MD; Carmen Centeno Clemente, MBBS; Pere Vila, MD; Javier Flandes, MD; Felipe Andreo, MD; Andrés Briones, MD; Enrique Cases Viedma, MD
Author and Funding Information

Hospital Universitari i Politècnic la Fe, Valencia, Spain

Chest. 2014;145(3_MeetingAbstracts):492A. doi:10.1378/chest.1809553
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SESSION TITLE: Bronchoscopy and Interventional Procedures Posters

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: To know about the degree of patients’ tolerance of the endobronchial ultrasound (EBUS) using different sedation models.

METHODS: Three hospitals participated in the survey: Hospital ‘La Fe’ (n=95), University Hospital ‘Germans Trias I Pujol’ (n=78), and Foundation Hospital ‘Jiménez Díaz’ (n=75). Sedation models were: A) midazolam bolus; B) propofol perfusion; C) midazolam bolus and propofol perfusion; D) propofol perfusion and remiphentanil-perfusion; E) midazolam bolus and fentanyl bolus. Either an endoscopist or an anesthetist controlled the sedation level assisted by nurses. A questionnaire Likert-type scale of 12 questions with multiple answers was delivered after 30 minutes (1=very low; 2=low; 3=somewhat low; 4=quite a lot; 5=a lot). This monitored remembrance, pain, cough and dyspnea during physical examination, duration sensation, fear-nervousness before EBUS, fear-nervousness and indifference if redone the test, the levels of anxiety and discomfort generated, the worst moment registered, and patient’s acceptance if the EBUS needs to be redone. Variables were analyzed with ANOVA and post-hoc tests.

RESULTS: 263 were analyzed and 23 excluded for incomplete. Patients were sedated following the model A 23, B 34, C 84, D 27 and E 72. Post-hoc tests showed two significantly homogeneous groups (sedation models A, E; and B, C, D) for cough perception, pain, dyspnea and remembrance. For the rest of parameters, two groups were differentiated: model E and groups A, B, C, D. Total valuation of the answers with the sedation model (mean ± standard deviation) was: A=1,82±1,12; B=1,53±0,74; C=1,55±0,85; D=1,64±0,8; E=2,27±1,16. 46.6% of patients did not find any discomfort; the worst moments were when anesthetized (17.5%) and when introducing the endoscope (15.4%). 89.6% of patients would rerun examination if needed.

CONCLUSIONS: EBUS is well accepted with the five sedation models by patients. Models A and E had a worse control of the symptoms according to their memories.

CLINICAL IMPLICATIONS: Endobronchial Ultrasound can be succesfully done with either model of sedation, so the experience of the endoscopist is the most important factor to choose a model.

DISCLOSURE: The following authors have nothing to disclose: José Ferrando, Iker Fernández-Navamuel, Carmen Centeno Clemente, Pere Vila, Javier Flandes, Felipe Andreo, Andrés Briones, Enrique Cases Viedma

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