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.