Sedation techniques in interventional flexible bronchoscopy and endobronchial ultrasound-guided transbronchial-needle aspiration (EBUS-TBNA) are inconsistent and the evidence for required
general anesthesia under full anesthesiologic involvement is scarce. Moreover, we faced the challenge of providing bronchoscopic care with limited personnel. Hence, we retrospectively identified 513 patients that underwent flexible interventional bronchoscopy and/or EBUS-TBNA out of our institution between January 2020 and August 2022 to evaluate our deep analgosedation approach based on
pethidine/
meperidine bolus plus continuous flow adjusted
propofol, the bronchoscopist-directed continuous flow
propofol based analgosedation (BDcfP) in a two-personnel setting. Consequently, 502 out of 513 patients received BDcfP for analgosedation. We identified cardiovascular comorbidities,
chronic obstructive pulmonary disease, and arterial
hypertension as risk factors for periprocedural
hypotension.
Propofol flow rate did not correlate with
hypotension.
Theodrenaline and
cafedrine might be used to treat periprocedural
hypotension. Moreover,
midazolam might be used to support the
sedative effect. In conclusion, BDcfP is a safe and feasible
sedative approach during interventional flexible bronchoscopy and EBUS-TBNA. In general, after the implementation of safety measures, EBUS-TBNA and interventional flexible bronchoscopy via BDcfP might safely be performed even with limited personnel.