| American College of Chest Physicians consensus statement on the use of topical anesthesia, analgesia, and sedation during flexible bronchoscopy in adult patients. | |
| | |
MedLine Citation:
|
PMID: 22045879 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Optimal performance of bronchoscopy requires patient's comfort, physician's ease of execution, and minimal risk. There is currently a wide variation in the use of topical anesthesia, analgesia, and sedation during bronchoscopy. METHODS: A panel of experts was convened by the American College of Chest Physicians Interventional/Chest Diagnostic Network. A literature search was conducted on MEDLINE from 1969 to 2009, and consensus was reached by the panel members after a comprehensive review of the data. Randomized controlled trials and prospective studies were given highest priority in building the consensus. RESULTS: In the absence of contraindications, topical anesthesia, analgesia, and sedation are suggested in all patients undergoing bronchoscopy because of enhanced patient tolerance and satisfaction. Robust data suggest that anticholinergic agents, when administered prebronchoscopy, do not produce a clinically meaningful effect, and their use is discouraged. Lidocaine is the preferred topical anesthetic for bronchoscopy, given its short half life and wide margin of safety. The use of a combination of benzodiazepines and opiates is suggested because of their synergistic effects on patient tolerance during the procedure and the added antitussive properties of opioids. Propofol is an effective agent for sedation in bronchoscopy and can achieve similar sedation, amnesia, and patient tolerance when compared with the combined administration of benzodiazepines and opiates. CONCLUSIONS: We suggest that all physicians performing bronchoscopy consider using topical anesthesia, analgesic and sedative agents, when feasible. The existing body of literature supports the safety and effectiveness of this approach when the proper agents are used in an appropriately selected patient population. |
| | |
Authors:
|
Momen M Wahidi; Prasoon Jain; Michael Jantz; Pyng Lee; G Burkhard Mackensen; Sally Y Barbour; Carla Lamb; Gerard A Silvestri |
Related Documents
:
|
21623059 - Ambiguous genitalia: two decades of experience. 22235599 - Factors associated with inpatient mortality in a field hospital following the haiti ear... 22155559 - Awareness of surveillance recommendations among patients with colorectal adenomas. 21571309 - Parathyroidectomy in the elderly: analysis of 7313 patients. 22153979 - Gender and the functional outcome of elderly ischemic stroke patients. 22021339 - Verbal exchange structure of general practice consultations with patients presenting ps... 21623059 - Ambiguous genitalia: two decades of experience. 3962639 - Mortality after cervical hip fracture. 3002 patients followed for 6 years. 16645229 - Jaw complications associated with bisphosphonate use in patients with plasma cell dyscr... |
Publication Detail:
|
Type: Consensus Development Conference; Journal Article |
Journal Detail:
|
Title: Chest Volume: 140 ISSN: 1931-3543 ISO Abbreviation: Chest Publication Date: 2011 Nov |
Date Detail:
|
Created Date: 2011-11-02 Completed Date: 2011-12-29 Revised Date: 2012-08-22 |
Medline Journal Info:
|
Nlm Unique ID: 0231335 Medline TA: Chest Country: United States |
Other Details:
|
Languages: eng Pagination: 1342-50 Citation Subset: AIM; IM |
Affiliation:
|
Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA. momen.wahidi@duke.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Analgesia / methods* Analgesics / therapeutic use* Anesthesia, Local / methods* Anesthetics, Local / therapeutic use* Bronchoscopy / methods* Conscious Sedation / methods* Humans Hypnotics and Sedatives / therapeutic use* |
| Chemical | |
Reg. No./Substance:
|
0/Analgesics; 0/Anesthetics, Local; 0/Hypnotics and Sedatives |
| Comments/Corrections | |
Comment In:
|
Chest. 2012 Jun;141(6):1640-1; author reply 1641
[PMID:
22670032
]
Chest. 2012 Apr;141(4):1125; author reply 1125-6 [PMID: 22474162 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Thoracic ultrasonography for the pulmonary specialist.
Next Document: Negative pressure pulmonary edema following bronchospasm.