title: Assessment of perianesthesic data in subjects undergoing endobronchial ultrasound-guided transbronchial needle aspiration.
abstract: BACKGROUND
  Transbronchial needle aspiration using endobronchial ultrasonography (EBUS-TBNA), a new minimally invasive diagnostic procedure, has been used to evaluate intrathoracic lymph nodes. It has been reported that EBUS-TBNA can be performed safely under sedation and provides a high level of patient satisfaction. We aimed to describe perianesthetic data, and compare results regarding the agents of subjects undergoing EBUS-TBNA under deep sedation.
  
  
  METHODS
  After ethics committee approval, perianesthetic data of 571 subjects undergoing EBUS-TBNA were analyzed retrospectively. Data were collected from anesthesia evaluation and observation forms. Four groups received anesthesia in the operating room as follows: propofol-midazolam (group PM), propofol-ketamine (group PK), propofol-ketamine-midazolam (group PKM), or propofol (group P). Dosage, number of anesthetic injection, hemodynamic variables, recovery time, complications, and patient satisfaction were also recorded.
  
  
  RESULTS
  Propofol consumption was higher in groups P and PM compared with groups PK and PKM. Midazolam requirement was higher in group PM than in group PKM. Recovery time was shorter in group P compared with groups PK, PM, and PKM. It was also shorter in groups PK and PM compared with group PKM. All of these differences were statistically significant. Temporary desaturation (n = 41; 7%) and increased blood pressure (n = 78; 14%) were predominant complications. In groups PK and PKM, risk of developing hypertension was higher than in groups PM and P (P < .001). The percentage of subjects satisfied with the procedure was 99%.
  
  
  CONCLUSIONS
  Independent from the sedative agent, deep sedation can be safe, and provide high patient satisfaction during EBUS-TBNA. The combination of ketamine with propofol or midazolam required lower doses of these anesthetics. However, the incidence of increased blood pressure was higher in groups administered ketamine. Recovery time was the shortest in group P, and the longest in group PKM. There was no relation between recovery time and total dose of anesthetics or presence of chronic disease.
authors.affiliation: Department of Anesthesiology and Reanimation, Ataturk Chest Diseases and Thoracic Surgery Education and Research Hospital, Ankara, Turkey hilalgun@yahoo.com.
authors.forename: Hilal
authors.initials: H
authors.lastname: Sazak
authors.affiliation: Department of Anesthesiology and Reanimation, Ataturk Chest Diseases and Thoracic Surgery Education and Research Hospital, Ankara, Turkey.
authors.forename: Mehtap
authors.initials: M
authors.lastname: Tunç
authors.affiliation: Department of Anesthesiology and Reanimation, Ataturk Chest Diseases and Thoracic Surgery Education and Research Hospital, Ankara, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Alagöz
authors.affiliation: Department of Anesthesiology and Reanimation, Ataturk Chest Diseases and Thoracic Surgery Education and Research Hospital, Ankara, Turkey.
authors.forename: Polat
authors.initials: P
authors.lastname: Pehlivanoğlu
authors.affiliation: Department of Chest Diseases and Tuberculosis, Ataturk Chest Diseases and Thoracic Surgery Education and Research Hospital, Ankara, Turkey.
authors.forename: Nilgün Yılmaz
authors.initials: NY
authors.lastname: Demirci
authors.affiliation: Department of Chest Diseases and Tuberculosis, Ataturk Chest Diseases and Thoracic Surgery Education and Research Hospital, Ankara, Turkey.
authors.forename: İbrahim O
authors.initials: İO
authors.lastname: Alıcı
authors.affiliation: Department of Chest Diseases and Tuberculosis, Ataturk Chest Diseases and Thoracic Surgery Education and Research Hospital, Ankara, Turkey.
authors.forename: Aydın
authors.initials: A
authors.lastname: Yılmaz
mesh_terms: D000328:Adult; D000368:Aged; D000762:Anesthesia Recovery Period; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D001999:Bronchoscopy / Q000379:methods; D016292:Procedural Sedation / Q000379:methods*; D004359:Drug Therapy, Combination; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D005260:Female; D006801:Humans; D007649:Ketamine / Q000008:administration & dosage*; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008874:Midazolam / Q000008:administration & dosage*; D008875:Middle Aged; D017060:Patient Satisfaction; D015742:Propofol / Q000008:administration & dosage*; D012189:Retrospective Studies; D013896:Thoracic Diseases / Q000000981:diagnostic imaging / Q000473:pathology
chemical_list: D018686:Anesthetics, Intravenous; D007649:Ketamine; D008874:Midazolam; D015742:Propofol
keywords: endobronchial ultrasound-guided transbronchial needle aspiration; ketamine; midazolam; propofol; sedation