This information describes your endobronchial ultrasound procedure at Memorial Sloan Kettering Cancer Center (MSKCC).
The mediastinum is the area between your right and left lung (see figure). It contains many structures, including lymph nodes. The endobronchial ultrasound (EBUS) procedure uses a small camera to let us look into the airway and sound waves to let us see structures through the wall of the airway. Samples of the lymph nodes and any masses can also be taken at this time. These can be examined to see if they have any cancer cells. This helps the doctor decide the type of treatment that will be best for you.
Preparation for the Procedure
- At a clinic visit, your doctor will explain the procedure to you. He or she will answer all of your questions.
- You will need to have Pre-Surgical Testing (PST). This should be done at least 48 hours prior to your procedure. It will include blood work and an electrocardiogram (EKG). An EKG is a test that measures the electrical activity of the heart. You will also meet with a nurse practitioner to discuss anesthesia.
- Tell your doctor if you take:
- Aspirin or products containing it (e.g. Bufferin®, Anacin®)
- NSAIDs, such as ibuprofen (Advil®) or naproxen (Aleve®)
- Vitamin E
These can cause bleeding problems. Your nurse will give you a fact card that tells you when to stop taking them and what you can take instead.
- Tell your doctor if you take a blood thinner such as Coumadin® or Plavix®. Do not stop taking these without speaking to your doctor first.
- Tell your doctor if you are taking any other medicines or have changed medicines. Some may interact with the anesthesia you will be given. Include:
- Medicines that do and do not require a prescription
- Herbal remedies
- Dietary supplements
- A nurse will call you 24-48 hours before the EBUS. He or she will review your medical history and the instructions. Be sure to ask any questions you have at this time.
- Do not eat or drink anything after midnight the night before your EBUS. If you will go home the same day of the EBUS, you must have a responsible adult care partner take you. If we can not confirm your care partner, your procedure will be canceled.
Day of the Procedure
- Take any medicine you have been told to take with a small sip of water.
- Report to the Pre-Surgical Center at the appointed time. Enter the hospital through the main entrance at 1275 York Avenue. Take the escalator to the first floor. Turn left into the corridor and go to the “B” elevators. Take the elevator to the 6th floor. Check in at the concierge desk.
- The morning of your EBUS, a nurse will review your medical history and check your:
- Blood pressure
- Respiratory rate
- You will be asked to change into a hospital gown. You will need to remove any dentures, contact lenses, or eyeglasses. Give them to your care partner to hold for safe keeping.
- Shortly after changing, you will go to the operating room. The total time in the operating room is about 45 minutes.
- Your care partner will be told when and where to meet you afterwards.
Explanation of Procedure
- Your doctor will review the procedure with you.
- An IV (intravenous) line will be placed in a vein in your arm. EKG leads will be attached to your chest to monitor your heart rate.
- You will get some medicine to make you feel drowsy. It is given to you through your IV. You may also be given general anesthesia. This is a medicine that will put you to sleep. If you get this, a small breathing tube will be placed into your mouth, past your throat.
- The doctor will spray some medicine into the back of your mouth to numb your throat.
- A thin, flexible telescope (bronchoscope) is put into your mouth. It is gently moved down the back of the throat into the area between the lungs. Pictures of this area are taken with an ultrasound probe. The probe is attached to the bronchoscope. Your doctor will use these pictures as a guide to take the samples. The samples are taken using a needle that is attached to the end of the probe. Cells may be taken from lymph nodes or masses that look abnormal.
- Once the procedure is complete, the breathing tube will be removed, if used. You will then be brought to the Post Anesthesia Care Unit (PACU).
After the Procedure
You will stay in the PACU until you are fully awake. This usually takes about two hours. During this time a nurse will check on you every 15 to 30 minutes. You may be given oxygen through small tubes that will rest just below your nose. You will not be able to eat or drink anything until the medicine used to numb your throat has worn off. You will be able to eat and drink once your gag reflex has returned.
Once you are fully awake, a chest x-ray will be done. You will meet your care partner and have something to eat and drink. Your IV line will be removed. Your doctor will talk to you about the procedure. Your nurse will give you discharge instructions.
You may have a sore throat for a day or two. Throat lozenges or ice chips may help ease the soreness. Call your doctor's office in three days to get the final results.
Call Your Doctor or Nurse if You:
- Have a fever of 100.4° F (38.0° C) or greater.
- Have difficulty breathing or shortness of breath.
- Have chest pain or a feeling of pressure in your chest.
- Cough up more than a teaspoon of blood. (It is normal to have a small amount of blood in the sputum you cough up.)
- A rapid heart beat.
Call 911 (emergency medical services, EMS) immediately or go to the closest emergency room if you have new or increased chest pain.