What is EBUS-TBNA?
EBUS-TBNA (EndoBronchial UltraSound-guided Transbronchial
Needle Aspiration) is a safe and effective technique that allows
the doctor to investigate your lungs and take samples of the lymph
glands located in the chest. Lymph glands (sometimes called lymph
nodes) are an important part of the immune system and are joined
together by lymph channels; they are normally pea sized.
A thin flexible telescope (bronchoscope) is passed down the
windpipe through the mouth. The bronchoscope is combined with
high frequency sound waves, transmitted from the ultrasound
probe at the tip of the bronchoscope. This allows a scanning of the
surrounding lymph glands. These glands are located outside the
breathing tubes and a fine needle is used to take samples.
This is day case procedure and done under conscious sedation and
local anaesthesia.
Why do I need a EBUS-TBNA?
An EBUS-TBNA is usually suggested if there are abnormal
appearing lymph nodes identified on radiological scans. Sampling
these lymph nodes may help your doctor to get the diagnosis and
determine most appropriate route of treatment.
What are the risks?
• EBUS is generally a very safe procedure with risk of serious
complication being 1 in 1000.
• Minor complications include cough, sore throat, hoarse voice,
soreness in the chest and lung collapse.
• Occasionally you may cough up small streaks of blood; this
usually settles without requiring further treatment. Occasionally
you may develop a chest infection after the procedure. Please
see your GP if you start to become more poorly.
• Occasionally your oxygen levels may drop during the
procedure, and you may require extra oxygen for some time
afterwards. If you are an outpatient, there is a small chance
that you may need to be admitted to the hospital. This is more
likely to happen if your oxygen levels are not normal before the
procedure.
• Sometimes the airways constrict during or after the procedure
(bronchospasm). This is usually relieved with a nebuliser.
• Very rarely this procedure has been known to cause death
(fewer than 4 in 10,000 people). This risk is higher if your
general health is poor, and lower if you are otherwise healthy.
Preparation prior to the procedure
• You will be asked to sign the consent at the time of booking for
the procedure or on the day of the procedure.
• Please do not eat or drink anything for at least four hours before
coming to hospital.
• Please do not wear jewellery, nail varnish or make up.
• Bring all your medications with you.
• Please come to reception at Gastro-enterology at the time you
have been given.
• If you have allergies to any medications, please inform us.
For Patients taking blood thinning medications (anticoagulants
and antiplatelets):
Please inform us at the time of booking for the procedure if you take
Warfarin, Clopidogrel, Direct oral anti-coagulants (Rivaroxaban,
Apixaban, edoxaban, dabigatran) Prasugrel, Dipyridamole or other
blood thinning treatments including injections (eg. Low molecular
weight heparins: Dalteparin) as these may need to be temporarily
stopped before the bronchoscopy with a view to reduce the risk of
bleeding during or after the procedure.
Risk and benefit of withholding or stopping the above treatment will
be discussed prior to procedure.
For Patients who take insulin for diabetes:
• Your medication may need to be altered therefore, please
contact your diabetic nurse 3 days before the procedure for
advice.
How will the procedure be performed?
• When you arrived at Endoscopy unit, a member of staff will take
your name and a few details. A small needle will be placed in
your arm to enable us to give you the sedative drug.
• Sedation
– We recommend you have sedation, but you will not be “put to
sleep”.
– This will help you relax and make you more comfortable; you
may not remember anything about the procedure afterwards.
– If you have been given sedation, you must not drive for 24
hours. Have a friend or relative to escort you from the unit
to your home and someone need to stay with you overnight.
You are also advised not to operate machinery, drink alcohol
or sign any legally binding documents for 24 hours after the
procedure.
• When your procedure is due to start you will be taken to
bronchoscopy room. The back of your throat will be numbed
with local anaesthetic. This taste bitter and has the side effect
of making it difficult to swallow.
• A small plastic tube may be placed in your nose to give you
extra oxygen. A small sensor is placed on one of your fingers to
measure oxygen level in the blood.
• The doctor will then gently pass the EBUS bronchoscope to
look inside the airways and take samples as required; you may
be offered more anaesthetic or sedation to help address any
discomfort you may feel during the procedure.
• If necessary, the doctor may take a ‘photograph’ of any
abnormalities seen within the airways.
• The procedure usually lasts 30-40 minutes.
How will I feel during the procedure?
• The procedure will not hurt you and you will be able to breathe
normally.
• It may make you cough as the bronchoscope goes into your
airways.
What happens after the procedure?
You will be taken from the treatment room to the recovery area
where you will rest on the trolley. You will be monitored until most
effects of any medication given have worn off. After 1-2 hours you
will be taken to the discharge area. You will be advised on when to
start eating and drinking. If you require an outpatient appointment
this will be sent by post. Please follow the written instructions you
will be given on leaving the ward.
When do I know the results of the procedure?
• If samples have been taken, the results may take up to a week.
• The details of the results and necessary treatment will be
discussed with you by the referring doctor.
Additional Information
Please be aware on the day of your bronchoscopy you may be in the
unit for up to four hours
If you have any question, you may contact us between
9am – 5pm weekdays:
Endoscopy Unit: 01253 953917
Respiratory Secretaries: 01253 953478
Lung Specialist Nurses: 01253 955578
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Author Respiratory Department
Approved by Respiratory Business Meeting
Date of Publication 14/03/2025
Review Date 01/03/2028
Reference No PL/1379 (v2)
