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Medical Sciences (Basel, Switzerland) Jul 2022Vasovagal reactions are a benign but common outcome of interventional pain management procedures that can negatively impact patient care, including aborted procedures... (Review)
Review
Vasovagal reactions are a benign but common outcome of interventional pain management procedures that can negatively impact patient care, including aborted procedures and fear of future procedures that would otherwise help the patient. Research has been done on the incidence, risk factors, and management of vasovagal reactions resulting from such procedures, but less is known about how to prevent these reactions from occurring. In this paper, we present a literature review of the pathophysiology, incidence, risk factors, prevention, and management of vasovagal reactions during interventional pain management procedures, with an emphasis on the relative lack of research and conflicting advice on preventive measures. We found that moderate sedation and anxiolytics have been used prophylactically to prevent vasovagal reactions, but their side-effect profiles prevent them from being used commonly. Less studied is the prophylactic administration of antimuscarinics and IV fluids, despite the potential benefit of these measures and relatively low side-effect profile. We explore these topics here and offer advice for future research to fill the gaps in our knowledge.
Topics: Conscious Sedation; Humans; Incidence; Pain Management; Risk Factors; Syncope, Vasovagal
PubMed: 35893121
DOI: 10.3390/medsci10030039 -
Nursing Jul 2003
Topics: Adolescent; Emergency Nursing; Emergency Treatment; Female; Humans; Nursing Assessment; Syncope, Vasovagal
PubMed: 12851506
DOI: 10.1097/00152193-200307000-00069 -
Brain and Nerve = Shinkei Kenkyu No... Aug 2022Syncope is defined as the transient loss of consciousness due to cerebral hypoperfusion. Reflex syncope (neurally mediated syncope) is among all syncope, vasovagal...
Syncope is defined as the transient loss of consciousness due to cerebral hypoperfusion. Reflex syncope (neurally mediated syncope) is among all syncope, vasovagal syncope is among reflex syncope in addition. We frequently treated several patients with vasovagal syncope in our clinical situation. We report here the mechanisms and treatments of vasovagal syncope. Although this syncope has a low risk, the diagnosis and the treatments are complicated. Therefore, invasive treatments are necessary in selected patients. This article discusses the management procedures of syncope according to the guidelines and our clinical experience.
Topics: Consciousness; Humans; Syncope; Syncope, Vasovagal
PubMed: 35941792
DOI: 10.11477/mf.1416202162 -
BioMed Research International 2020An artificial liver support system (ALSS) is an effective therapy for patients with severe liver injury. A vasovagal reaction (VVR) is a common complication in various...
OBJECTIVE
An artificial liver support system (ALSS) is an effective therapy for patients with severe liver injury. A vasovagal reaction (VVR) is a common complication in various treatment settings but has not been reported previously in ALSS.
METHODS
This study retrospectively evaluated patients who suffered an ALSS-related VRR between January 2018 and June 2019. We collected data from VVR episodes including onset time, duration, changes in heart rate (HR) and blood pressure (BP), and drug treatment.
RESULTS
Among 637 patients who underwent ALSS treatment, 18 were included in the study. The incidence of VVR was approximately 2.82%. These patients were characterized by a rapid decrease in BP or HR with associated symptoms such as chest distress, nausea, and vomiting. The majority of patients (78%) suffered a VVR during their first ALSS treatment. Sixteen patients (89%) had associated symptoms after treatment began. Sixteen patients (89%) received human albumin or Ringer's solution. Atropine was used in 11 patients (61%). The symptoms were relieved within 20 min in 15 patients and over 20 min in 3 patients.
CONCLUSIONS
A VVR is a rare complication in patients with severe liver injury undergoing ALSS treatment. Low BP and HR are the main characteristics of a VVR.
Topics: Adult; Aged; Blood Pressure; Female; Heart Rate; Humans; Liver, Artificial; Male; Middle Aged; Syncope, Vasovagal; Young Adult
PubMed: 32733947
DOI: 10.1155/2020/6313480 -
Annales de Dermatologie Et de... Nov 2008
Topics: Anxiety; Bradycardia; Dizziness; Heart Rate; Humans; Incidence; Oxygen; Syncope, Vasovagal
PubMed: 19061666
DOI: 10.1016/j.annder.2008.05.014 -
Heart Rhythm Mar 2024
Topics: Humans; Syncope, Vasovagal; Syncope; Tilt-Table Test
PubMed: 38141900
DOI: 10.1016/j.hrthm.2023.12.011 -
Revue Medicale Suisse May 2014Vasovagal syncope is the main cause of syncope. The mechanism behind this syncope has not been clearly identified, but the main hypothesis is a paradoxical reaction of... (Review)
Review
Vasovagal syncope is the main cause of syncope. The mechanism behind this syncope has not been clearly identified, but the main hypothesis is a paradoxical reaction of the autonomic nervous system leading to hypotension and/or bradycardia. According to the recommendations of the European Society of Cardiology, the diagnosis can be made only on the basis of history. In patients where the diagnosis is not clear, we can offer to make a tilt test, which is, however, limited in terms of sensitivity and does not represent the gold standard. The initial management is primarily conservative. Pacing should still be revisit by future studies.
Topics: Cardiovascular Agents; Diagnostic Techniques, Cardiovascular; Head-Down Tilt; Humans; Stockings, Compression; Syncope, Vasovagal; Tilt-Table Test
PubMed: 24964525
DOI: No ID Found -
Transfusion Clinique Et Biologique :... May 2023Adverse donor reactions (ADR) are common to occur during the blood donation process. The most common is vasovagal reactions (VVR) and it cause negative impact in the...
Adverse donor reactions (ADR) are common to occur during the blood donation process. The most common is vasovagal reactions (VVR) and it cause negative impact in the donor return rate. The aim of this study is to determine the prevalence of VVR among blood donors and to study its associated factors, at Hospital University Sains Malaysia (USM). This retrospective case-control study was conducted from June 2018, until June 2021. Data was extracted from the blood bank database system and from donor adverse reaction form. Donors who developed adverse donor reactions were chosen and without VVR were chosen at random as controls. A total of 159 donors, out of 35 134 donors were reported to have VVR which resulted in an overall prevalence of 0.45 %. Dizziness or mild VVR were the most frequently observed adverse reactions, accounting for approximately 87/159 (54.7 %) of all adverse reactions. Multiple logistic regression (MLR) analysis showed VVR were significantly associated with age, female gender, first-time donor, and 450 ml volume of blood collected. The prevalence of vasovagal reactions among blood donors in this study was low which was similar to a few previous studies. Although it was low, still it is very important to reduce risks to a minimum so that the donor return rate could be maintained. The information regarding its associated factors can be used to identify high-risk donors to prevent the incidence in the future.
Topics: Humans; Female; Blood Donors; Retrospective Studies; Case-Control Studies; Prevalence; Malaysia; Syncope, Vasovagal; Hospitals, University
PubMed: 36702200
DOI: 10.1016/j.tracli.2023.01.004 -
Heart Rhythm Jun 2014
Topics: Adult; Electrocardiography; Exercise; Female; Humans; Pacemaker, Artificial; Syncope, Vasovagal
PubMed: 24016694
DOI: 10.1016/j.hrthm.2013.09.004 -
Herz Apr 2021The aim of this study was to analyze the risk factors for vasovagal reaction (VVR) in manual femoral sheath removal after percutaneous coronary intervention and to... (Observational Study)
Observational Study
BACKGROUND
The aim of this study was to analyze the risk factors for vasovagal reaction (VVR) in manual femoral sheath removal after percutaneous coronary intervention and to discuss methods for the prevention and control of VVR.
METHODS
The data of 455 patients who underwent percutaneous intervention in four interventional centers during a period of 30 months were retrospectively analyzed. Patients were divided into a VVR group and a control group according to whether VVR developed. The clinical data of all patients were analyzed using univariate and multivariate logistic regression analysis to examine VVR -related factors.
RESULTS
A total of 455 patients underwent 464 manual femoral sheath removal operations, of whom 12 developed VVR (2.59%). Of these 12 VVR patients, one had VVR during and 11 had VVR after the intervention. There were no statistically significant differences between the two groups in age, body mass index, gender, time of sheath removal, proportions of patients with hypertension, diabetes, and hyperlipemia, laboratory values of hemoglobin a1c, and ejection fraction (p > 0.05). Compared with the control group, use of nitrates was the only risk factor with a significant correlation with VVR (p = 0.012).
CONCLUSION
In manual femoral sheath removal, the use of nitrates is the most important risk factor for the occurrence of VVR after percutaneous intervention.
Topics: Femoral Artery; Humans; Nitrates; Retrospective Studies; Risk Factors; Syncope, Vasovagal
PubMed: 32291484
DOI: 10.1007/s00059-020-04916-0