2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.05A.01 Efficacy and Safety of Midazolam with Fentanyl for Sedation During EBUS-TBNA: A Randomized, Double-Blind, Phase III Study

EP.05A.01 Efficacy and Safety of Midazolam with Fentanyl for Sedation During EBUS-TBNA: A Randomized, Double-Blind, Phase III Study

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The study, conducted by Jun Yamada and colleagues, evaluates the efficacy and safety of a combination of midazolam and fentanyl for sedation during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). It's a randomized, double-blind, phase III trial following the British Thoracic Society guidelines, which suggest the use of benzodiazepines or propofol with opioids for procedures like flexible bronchoscopy (FB). <br /><br />The trial included patients aged 20 or older with mediastinal or hilar lymph nodes accessible by EBUS-TBNA, excluding those with allergies to the drugs or who were using strong opioids. Participants were administered midazolam and fentanyl, with additional doses permitted during the procedure. The study primarily measured the sedation level, frequency of additional sedative administration, and the number of successful needle punctures.<br /><br />Out of 95 patients undergoing FB, 87 proceeded with EBUS-TBNA. The results highlighted that sedation using midazolam with fentanyl led to better patient outcomes, as demonstrated by the significantly higher frequency of three or more successful punctures in the fentanyl group compared to the placebo group. Additionally, the fentanyl group's incidence of sedative-induced delirium was lower, suggesting the opioid's potential to enhance midazolam's effectiveness while reducing its dosage and minimizing adverse effects.<br /><br />Overall, the study concludes that combining fentanyl with midazolam for sedation during EBUS-TBNA can enhance procedural effectiveness and safety without increasing complications, thus suggesting it as a viable sedation regimen for such diagnostic procedures.

Asset Subtitle

Jun Yamada

Meta Tag

Speaker Jun Yamada

Topic Pulmonology and Staging

Keywords

midazolam

fentanyl

sedation

endobronchial ultrasound

transbronchial needle aspiration

randomized trial

British Thoracic Society

patient outcomes

sedative-induced delirium

diagnostic procedures