Abstract
Aim: To determine non inferiority of conscious sedation compared with general anaesthetic (GA) for bronchoscopic procedures, in terms of patient comfort and satisfaction.
Methods: Patients undergoing therapeutic and diagnostic procedures within the RBWH were considered for trial entry and randomisation. Procedures included standard diagnostic bronchoscopy, endobronchial convex probe ultrasound (EBUS) or transbronchial radial probe. Patients were randomised to either conscious sedation or GA, stratified for Charlson Comorbidity Index. Conscious sedation was by Thoracic Physicians and did not include Propofol; GA patients had Laryngeal mask airway. Patient comfort was assessed by pre and post procedural visual analogue scales. Secondary endpoints including medical staff assessment of comfort, peri-procedural complications, resource use and depth of anaesthesia as measured by Bispectral (BIS) analysis, were also measured.
Results: At total of 75 patients were randomised. There was no significant difference in comfort scores between conscious sedation and GA groups for both binary (p=0.62) and 10 point visual analogue scales 2.1±0.2 vs. 2.2±0.2 (p=0.65). There was no significant difference between comfort scores as assessed by the proceduralist, however assessment by the assisting nurse showed significant improvement for the GA group (p=0.01). There were significantly higher peri-procedural complications within the GA group, 10 vs. 3 (p=0.02), as well as higher IV fluid volume requirements, 383ml±62 vs. 244ml± 27 (p=0.04), higher staff numbers 6.0±0.2 vs. 4.5±0.2 (p<0.05) and deeper sedation levels as measured by BIS (p<0.05).
- Copyright ©ERS 2015
