Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is usually performed with support from an anesthesiology team (AT). However, coordinating with ATs limit the number of performed procedures. Alternatively, moderate sedation can be administered by bronchoscopists.

We wished to assess the safety of EBUS-TBNA without ATs and to investigate the most commonly employed sedation modalities in our tertiary centre.

Out of N=891 EBUS-TBNAs from our registry, N=192 (21.5%) were performed without ATs. The most common AE was patient desaturation, which occured in 2.7% of procedures with vs. 3.2% of procedures without AT; not statistically significant, p=0.7. Bleeding that required administration of adrenaline and/or tranexamic acid occured in 1.9% of procedures with ATs vs. 1.8% of procedures without ATs; not statistically significant, p=0.8. In all cases from our registry, AEs were successfully managed, regardless of AT presence. No AEs requiring intensive care or lethal outcomes during or immediately related to EBUS-TBNAs were observed.
No difference in diagnostic yield was observed between two groups (p=0.4).

In cases were bronchoscopists administered sedation medications, the most common modality was intravenous midazolam and propofol (48%), followed by administering midazolam only (43%); a combination of midazolam and dexmedetomidine was employed in 3% of cases.

Registry-based data from the first centre to perform EBUS-TBNA in Croatia, suggest non-inferiority of EBUS-TBNA without ATs. However, prospective controlled trials are required to further confirm this.