Impact of anesthesia on cytology quality obtained during EBUS-TBNA, EUS-b-FNA or EUS-FNA in patients with mediastinal adenopathies

Aim: Little is still known regarind the impact of anesthesia on efficacy of EBUS-TBNA, EUS-b-FNA and EUS-FNA. Methods: 87 pts (53 males) referred for endosconography for mediastinal adenopathy were included. Total number of needle passes reached 187. Type of procedure, type of anesthesia, cytology quality and procedure duration were assessed. Results: Mean procedure diration for EUS-b-FNA was 9 min, reaching 7 min with local anesthesia and 13 min under sedation. For EUS-FNA, the same parameters were 15, 14, and 20 min, respectively. For EBUS-TBNA, the same data were 24, 14 and 20 min respectively. For EBUS-TBNA, representative metherial was retrieved in 77% of passes under local anesthesia, in 57% under sedation, and in 100% under generalanesthesia. For EUS-FNA, representative smears were obtained in 80% under local anesthesia, 60% under sedation, and 100% under general anesthesia. For EUS-b-FNA, the same data were 78%, 30%, and 83% respectively. In total, 79%, 44% and 96% of passes were representative for local anesthesia, sedation, and general anesthesia respectively. Conclusion: Different types of anesthesia during endosonography have a distinct impact on quality of cytology smears obtained in procedure. Independently from procedure type, and surpisingly, sedation led to lower quality of smears.