Electromagnetic navigation bronchoscopy under intravenous sedation-tips and tricks.

Area of Science:

• Pulmonology
• Medical Imaging
• Interventional Pulmonology

Background:

• Electromagnetic navigation bronchoscopy (ENB) is an increasingly utilized tool for diagnosing pulmonary nodules (PNs).
• Historically, ENB procedures were predominantly performed under general anesthesia (GA).
• Emerging evidence suggests ENB under intravenous sedation (IVS) may offer comparable diagnostic yield and reduce procedure time.

Purpose of the Study:

• To review the techniques essential for performing ENB under intravenous sedation (IVS).
• To outline strategies for maximizing diagnostic yield and ensuring patient safety during ENB with IVS.
• To explore the potential of IVS to increase accessibility to ENB procedures.

Main Methods:

• Review of techniques for electromagnetic navigation bronchoscopy (ENB).
• Focus on procedural modifications and safety considerations for ENB performed under intravenous sedation (IVS).
• Comparison of ENB under IVS versus general anesthesia (GA) regarding technical challenges and outcomes.

Main Results:

• ENB under IVS demonstrates comparable diagnostic yield to ENB under GA.
• ENB under IVS is time-saving compared to ENB under GA.
• ENB under IVS presents unique technical challenges compared to GA.

Conclusions:

• Electromagnetic navigation bronchoscopy (ENB) under intravenous sedation (IVS) is a viable alternative to GA for diagnosing pulmonary nodules.
• Mastering specific techniques is crucial for optimizing the safety and diagnostic efficacy of ENB with IVS.
• Wider adoption of ENB with IVS could improve patient and practitioner access to this diagnostic modality.