Valoración de la tolerancia y seguridad de 5 modelos de sedación durante la realización de la ecobroncoscopia

Viedma, Enrique Cases; García, Felipe Andreo; Aldeyturriaga, Javier Flandes; Mezquida, Juan Pablo Reig; Gómez, Andrés Briones; Caral, Pere Vila; Basozabal, Iker Fernández-Navamuel; Clemente, Carmen Centeno; Campo, Felipe; Martínez, Estefanía Sánchez; Moret, Francisca Sanchís; Pérez, Josefina Manjón; Yepes, Marina Sánchez

doi:10.1016/j.arbres.2015.04.005

Cited by 14 publications

(5 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This percentage is greater than in other studies, as our criterion for hypotension was a reduction of 20% from the baseline mean blood pressure, not a 30% drop [21]. Hypotension events resolved spontaneously after adjusting sedative doses in accordance with sedation protocol (BIS and clinical in non-BIS, respectively) or increasing fluid therapy.…”

Section: Discussionmentioning

confidence: 51%

“…The incidence in the BIS group was far lower than that reported by Jensen [20] (50%), who used only propofol, though at higher doses, and by Vila [17] (47.8%), who also used remifentanil. The incidence in the Cases Viedma et al [21] series, with a combination of propofol and remifentanil, was similar to that in our BIS group (12.9%), although this multicenter study did not specify the dose or level of sedation. This lower hypoxemia is attributable to less severe respiratory depression, with less compromising of the airway, due to the more limited use of propofol and, therefore, less severe relaxation of the pharyngeal muscles, and to the lower incidence of bradypnea in the BIS group.…”

Section: Discussionmentioning

confidence: 75%

“…These adverse events with the longer duration are considered to be linked to the higher doses of sedatives, and it has been suggested that doses of ≥100 mg of propofol lead to more adverse events. Other authors found no relationship between adverse events and the duration of EBUS-TBNA [10,21], but the mean duration of their procedures was shorter. Our longer mean duration may have been due to the learning curve of the residents and the systematic triple puncture of all lymph node stations punctured, which included lymph nodes not captured on the positron emission tomography scan.…”

Section: Discussionmentioning

confidence: 99%

“…Mild-to-moderate sedation with benzodiazepines and opioids [18,19] is the type of sedation commonly used by pulmonologists, whereas moderate-to-deep sedation with propofol, alone or in association with opioids [11,20,21], requires the presence of personnel trained to use these drugs, according to current guidelines [22,23,24,25]. Anesthesia protocols vary between hospitals and countries, and no protocol is applied uniformly.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Bispectral Index Monitoring Reduces the Dosage of Propofol and Adverse Events in Sedation for Endobronchial Ultrasound

Quesada

Júdez²,

Ubieto³

et al. 2016

Respiration

View full text Add to dashboard Cite

Background: Current guidelines recommend monitoring the anesthetic depth of sedation during respiratory endoscopy by using clinical scales despite their subjective nature and the potential change in the level of sedation caused by frequent stimulation. Monitoring by means of the bispectral index (BIS) has shown its utility in reducing the use of drugs and their adverse events in general anesthesia, but evidence in prolonged sedation is insufficient. Objective: Our objective was to evaluate BIS in patients undergoing endobronchial ultrasound (EBUS). Methods: A randomized cohort study of 90 patients with mediastinal lymph node involvement and/or lung or mediastinal lesions for whom EBUS was indicated, comparing the modified observer's assessment of alertness/sedation scale clinical evaluation (n = 45) versus the BIS evaluation (n = 45) of sedation with propofol-remifentanil, was conducted in order to evaluate the clinical parameters, doses used, adverse events, and tolerance of the procedure. Results: We found a shorter waking time and a significantly lower dose of total propofol in the BIS group. Significantly fewer overall adverse events were recorded in the BIS group and included desaturation, hypotension, and bradypnea. Tolerance was better in the BIS group. No significant differences were found in terms of cough, memory of the procedure, or the level of difficulty of EBUS on the part of the pulmonologists. Conclusions: BIS monitoring of sedation in EBUS makes it possible to reduce the dosage of propofol, thereby shortening the waking time and reducing adverse events. This form of monitoring should be taken into consideration in the future for systematic use in prolonged sedation, as in the case of EBUS.

show abstract

Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Bispectral Index Monitoring Reduces the Dosage of Propofol and Adverse Events in Sedation for Endobronchial Ultrasound

Quesada

Júdez²,

Ubieto³

et al. 2016

Respiration

View full text Add to dashboard Cite

show abstract

“…That could be due to a lack of resources (human or material) or to medical idiosyncrasies. The fact that the proportion of physicians who believed that bronchoscopy does not require sedation was greater among those ≥ 45 years of age could be explained by a lack of experience with drugs used for short duration procedures, such as propofol, 9 , 15 , 16 remifentanil, 17 , 18 and dexmedetomidine, 19 , 20 which have been introduced relatively recently. The difference between younger and older physicians could also be a result of the fact that respiratory medicine training a few decades back was more focused on tuberculosis, whereas residents in respiratory medicine now receive training that focuses more on critical care.…”

Section: Discussionmentioning

confidence: 99%

Sedation for bronchoscopy: current practices in Latin America

Rubinstein-Aguñín

García-Choque²,

López-Araoz³

et al. 2020

J. bras. pneumol.

View full text Add to dashboard Cite

Objective: To evaluate current practices in sedation for bronchoscopy in Latin America. Methods: This was an anonymous survey of select members of the Latin American Thoracic Association. The questionnaire, made available online from November of 2015 through February of 2016, was designed to collect data on demographic characteristics; type of facility (public or private); type/volume of bronchoscopies; type of sedation; and type of professional administering the sedation. Results: We received 338 completed questionnaires from 19 countries; 250 respondents (74.0%) were male. The mean respondent age was 36.0 ± 10.5 years. Of the 338 respondents, 304 (89.9%) were pulmonologists; 169 (50.0%) worked at public facilities; and 152 (45.0%) worked at teaching facilities. All of the respondents performed diagnostic fiberoptic bronchoscopy, 206 (60.9%) performed therapeutic fiberoptic bronchoscopy, 125 (37.0%) performed rigid bronchoscopy, 37 (10.9%) performed endobronchial ultrasound, and 3 (0.9%) performed laser therapy/thermoplasty/cryotherapy. Sedation for bronchoscopy was employed by 324 respondents (95.6%). Of the 338 respondents, 103 (30.5%) and 96 (28.4%) stated, respectively, that such sedation should “usually” and “never” be administered by a bronchoscopist; 324 (95.9%) supported training bronchoscopists in sedation. Sedation administered by a bronchoscopist was reported by 113 respondents, conscious sedation being employed by 109 (96.2%). The use of benzodiazepines, propofol, and opiates was reported, respectively, by 252 (74.6%), 179 (52.9%), and 132 (39.0%) of the 338 respondents. Deep sedation and general anesthesia were more common at private facilities. Conclusions: The consensus seems to be that a well-trained bronchoscopist can safely administer sedation for bronchoscopy. However, approximately 40% of bronchoscopists do not do so regularly.

show abstract

Anesthesia for Routine and Advanced Upper Gastrointestinal Endoscopic Procedures

Sharp

Tayler

Ginsberg

2017

Anesthesiology Clinics

View full text Add to dashboard Cite

Valoración de la tolerancia y seguridad de 5 modelos de sedación durante la realización de la ecobroncoscopia

Cited by 14 publications

References 17 publications

Bispectral Index Monitoring Reduces the Dosage of Propofol and Adverse Events in Sedation for Endobronchial Ultrasound

Bispectral Index Monitoring Reduces the Dosage of Propofol and Adverse Events in Sedation for Endobronchial Ultrasound

Sedation for bronchoscopy: current practices in Latin America

Anesthesia for Routine and Advanced Upper Gastrointestinal Endoscopic Procedures

Contact Info

Product

Resources

About