title: Endobronchial ultrasound-guided transbronchial needle aspiration: patient satisfaction under light conscious sedation.
abstract: BACKGROUND
  Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an increasingly used mediastinal sampling technique. Many centres use conscious 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 knowledge, ours is the largest prospective study evaluating the experience of patients undergoing EBUS-TBNA using light conscious sedation without propofol.
  
  
  OBJECTIVE
  To evaluate the patient tolerability of EBUS-TBNA under mild conscious 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 mediastinal disease due to malignancy or granulomatous disease were invited to complete a questionnaire after the intervention. 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 sedative agents administered was 59.4 μg fentanyl and 3.2 mg midazolam. The sensitivity of EBUS-TBNA for the cancer staging, 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 definitely or probably undergo a repeat EBUS-TBNA.
  
  
  CONCLUSIONS
  This single-centre UK study confirms that EBUS-TBNA under light conscious sedation is a well-tolerated procedure maintaining the expected diagnostic performance, with patients reporting a high degree of satisfaction with both the test and the information received beforehand.
authors.affiliation: North Bristol Lung Centre, North Bristol NHS Trust, Southmead Hospital, Bristol, UK.
authors.forename: Abiramy
authors.initials: A
authors.lastname: Jeyabalan
authors.forename: Andrew R L
authors.initials: AR
authors.lastname: Medford
mesh_terms: D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D001999:Bronchoscopy / Q000379:methods; D002277:Carcinoma / Q000473:pathology; D016292:Procedural Sedation / Q000379:methods*; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use*; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008874:Midazolam / Q000627:therapeutic use*; D008875:Middle Aged; D009367:Neoplasm Staging; D017060:Patient Satisfaction; D011446:Prospective Studies; D017565:Sarcoidosis, Pulmonary / Q000473:pathology; D012680:Sensitivity and Specificity; D014397:Tuberculosis, Pulmonary / Q000473:pathology
chemical_list: D018686:Anesthetics, Intravenous; D008874:Midazolam; D005283:Fentanyl