Study Design
Patients with mediastinal or hilar lesions that had an indication of EBUS-TBNA were evaluated. Eligible subjects without any serious and acute respiratory and/or cardiovascular disease were included in the study. Other exclusion criteria were the chronic hypoxemia (SpO2 90% at room air), regular use of benzodiazepine-related drugs and dementia. The study was planned as a randomized controlled trial. Patients were randomly assigned to two groups. Sample size was calculated by G power analysis. When the effect size was taken as 0,5, 80% power (1-beta), type 1 error rate (alpha) was calculated as 0,05, it was decided to take 30 patients in both groups. Group 1 was consisted of EBUS-TBNA procedure with nCPAP+Oxygen (6-14 mBar+4-10 lt/dk) and Group 2 with only Oxygen (4-10 lt/dk). EBUS-TBNA procedures were performed by the same pulmonologist. A flexible convex-probe ultrasonic-puncture bronchoscope with a linear scanning transducer at a frequency of 7,5 MHz (EB-530US, SU-8000 Endoscopic Ultrasound System, Fujifilm, Tokyo, Japan) and Standard 22-gauge needle (Medi-Globe, Germany) were used for EBUS-TBNA procedure. The procedure was performed under moderate IVS with the accompaniment of an anesthesiologist. After premedication with midazolam 0,25 mg/kg, fentanil received 1 mcg/kg infusion in all cases. Two minutes after the start of the remifentanil infusion, propofol was given as 0,5 mg/kg iv and the Ramsay sedation score was tried to be between 3-4. When additional dose was needed, 0,25 mg/kg propofol iv was given. Nasal CPAP (System One CPAP, Phillips Respironics, USA) was applied by another pulmonologist. Demographic data, comorbidities, smoking history, neck circumference, body mass index (BMI), and Mallampati indexes of the participants were recorded. All of the patients answered the STOP BANG Questionnaire [9] (Table 1). During the procedure; peripheral Oxygen saturation (SpO2), desaturation time, electrocardiogram, arterial blood pressure, anesthetic agents, sedation level, CPAP pressure, Oxygen concentration, complications, interventions, processing time, and practitioner satisfaction (best score: 5/5) were evaluated. After waking up in an average of 5 minutes, all patients sent to the recovery room. They were discharged after being kept under observation for 2 hours.