For a study, it was determined that data on the effect of sedative type on yield, complications, and tolerance of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) were mostly inconsistent and based on retrospective research to determine the type of sedation used affects EBUS-TBNA diagnostic yield, complication rates, and patient tolerability. Patients referred for EBUS-TBNA were randomly assigned (1:1) to have the procedure done under GA or mild sedation (MS). The primary outcome was “diagnostic yield,” which was the proportion of patients for whom EBUS-TBNA provided a precise diagnosis. A total of 149 patients underwent EBUS-TBNA, with 75 undergoing GA and 74 undergoing MS. The demographic and clinical features at the start of the study were fairly balanced. The GA group had 236 lymph nodes (LNs) and six masses sampled (average, 3.2 1.9 sites/patient), while the MS group had 200 LNs and six masses sampled (average, 2.8 1.5 sites/patient) (P=0.199). The diagnostic yields for the GA and MS groups were 70.7% (53 of 75) and 68.9% (51 of 74), respectively (P=0.816).
The GA group had a sensitivity of 98.2% (CI, 97–100%), and the MS group had a sensitivity of 98.1% (CI, 97–100%) (P=0.979). In the GA group, EBUS was completed in all patients, while in the MS group, they did in 69 patients (93.3%) (P=0.028). In either group, there were no severe problems or care escalation. Minor problems occurred more frequently in the MS group (29.6% vs 5.3%) (P<0.001). In both groups, most patients said they “certainly would” undertake the treatment again (P=0.355). Under MS, EBUS-TBNA yields diagnostic yield, major complication rate, and patient tolerance comparable to GA. The findings will need confirmation in future prospective multicenter investigations.
Reference:www.atsjournals.org/doi/full/10.1164/rccm.201409-1615OC
