@article {Lin00064-2020, author = {Ting-Yu Lin and Yu-Chen Huang and Chih-Hsi Kuo and Fu-Tsai Chung and Yu-Ting Lin and Tsai-Yu Wang and Shu-Min Lin and Yu-Lun Lo}, title = {Dexmedetomidine sedation for endobronchial ultrasound-guided transbronchial needle aspiration, a randomised controlled trial}, elocation-id = {00064-2020}, year = {2020}, doi = {10.1183/23120541.00064-2020}, publisher = {European Respiratory Society}, abstract = {Background and aim Appropriate sedation is important to the success of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Dexmedetomidine is a sedative agent that operates via the α2 adrenergic agonist, which provides sleep-like sedation with little respiratory suppression. The study compared the efficacy and safety of dexmedetomidine sedation with propofol in cases of EBUS-TBNA.Methods Patients requiring EBUS-TBNA were randomly assigned dexmedetomidine sedation (D, n=25) or propofol sedation (P, n=25). Vital signs, diagnostic yield, and the bispectral index (BIS) were recorded throughout the bronchoscopic procedure and recovery period. The tolerance and cooperation of the patients were evaluated using questionnaires.Measurements and Results The lowest mean arterial blood pressure in group D (79.2{\textpm}9.9 versus 72.5{\textpm}12.9 mmHg, p=0.049) exceeded that in group P, the lowest heart rate was lower (60.9{\textpm}10.2 versus 71.4{\textpm}11.8 beat{\textperiodcentered}min-1, p=0.006) and the mean BIS during sedation was significant higher (84.1{\textpm}8.3 versus 73.6{\textpm}5.7, p\<0.001). Patients in group D were more likely to report perceiving procedure-related symptoms and express an unwillingness to undergo the bronchoscopy again, if indicated (41.1 versus 83.3\%, p=0.007). One subject in group D aborted EBUS-TBNA due to intolerance. Many of the variables in the two groups were similar, including the proportion of hypoxemic event, recovery times, patient cooperation, and diagnostic yield.Conclusions The effects of dexmedetomidine on hemodynamics was in line with its pharmacodynamic features. Patients who received dexmedetomidine were more likely than those who received propofol to perceive the procedures. Overall, dexmedetomidine did not prove inferior to propofol sedation in terms of patient cooperation or diagnostic yield.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Lin has nothing to disclose.Conflict of interest: Dr. Huang has nothing to disclose.Conflict of interest: Dr. Kuo has nothing to disclose.Conflict of interest: Dr. Chung has nothing to disclose.Conflict of interest: Dr. Lin has nothing to disclose.Conflict of interest: Dr. WANG has nothing to disclose.Conflict of interest: Dr. Lin has nothing to disclose.Conflict of interest: Dr. Lo has nothing to disclose.}, URL = {https://openres.ersjournals.com/content/early/2020/09/10/23120541.00064-2020}, eprint = {https://openres.ersjournals.com/content/early/2020/09/10/23120541.00064-2020.full.pdf}, journal = {ERJ Open Research} }