Pleuroscopy Using Dexmedetomidine in a High-risk Patient.

Abstract

In Reply: It was a pleasure to find out that other groups have utilized dexmedetomidine as a sedation agent during pleuroscopy. Dr Kumar and colleagues are to be congratulated for also realizing the potential of the drug and for using it in their own patients. In regards to their comment; our group has been utilizing dexmedetomidine as a sedation agent since the development of the pleuroscopy service in our hospital in January 2017 (first case).1 In addition, our group has been investigating the optimal sedation agent combination for pleuroscopy as far back as 2014, a fact that Dr Kumar and colleagues have actually cited in their own paper.2 Finally, and most importantly, as the journal can also attest to this fact, the first submission of our report was on December 7, 2017, with final acceptance following revision on April 20, 2018. This is earlier or coincides with the publication of Dr Kumar and colleagues in Lung India in May-June 2018! It is well known that publication rates vary from journal to journal depending on volume and issue frequency for each periodical, however, it is established convention that an article is considered published from its date of acceptance. Therefore, in this case, it is possible that Dr Kumar’s statement “To our knowledge, this is the first reported case of the thoracoscopic pleural biopsy under local anesthesia and conscious sedation with fentanyl and dexmedetomidine in an adult patient” maybe the one actually incorrect! At the very maximum, conception and usage of this sedation approach for pleuroscopy was concurrent by both groups. Nevertheless, medicine is not about who got there first, but how to provide the best possible care to our patients and therefore it is truly a pleasure to see that dexmedetomidine usage in pleuroscopy is attracting more “converts” and so we hope more will follow Dr Kumar and colleagues’ example! Emmanouil I. Kapetanakis, MD, MSc* Tatiana Sidiropoulou, MD, PhD†Departments of *Thoracic Surgery†Anesthesiology and Pain Medicine “Attikon” University Hospital Athens, Greece