Patient Satisfaction During Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Performed Under Conscious Sedation

BACKGROUND: Mediastinal and hilar lymph node evaluation with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is being performed with increasing frequency. Original reports described performance under general anesthesia. Patient satisfaction is an important determinant of whether EBUS-TBNA may be performed under conscious sedation.

METHODS: Consecutive patients undergoing EBUS-TBNA under conscious sedation completed a self-administered questionnaire 2–4 hours after the procedure. Satisfaction was determined by patient willingness to return for the procedure in the future. Patients also reported degree of recall of the procedure and any distressing symptoms. Procedural data and complications were also recorded.

RESULTS: Forty-one patients underwent EBUS-TBNA, with no serious complications. The mean dose of topical airway anesthesia was 332 ± 51 mg lignocaine. The combinations and doses of intravenous sedative agents varied widely. Patient satisfaction was extremely high, with 40 patients (98%) reporting they would “definitely return” for EBUS-TBNA in the future if required, and one patient (2%) reporting he would “probably” return for such a procedure. To our knowledge, this is the highest reported patient satisfaction associated with a bronchoscopic procedure.

CONCLUSIONS: EBUS-TBNA may safely be performed under conscious intravenous sedation and is associated with very high patient satisfaction.