Vasovagal mediated cardiac arrest during epidural catheter insertion in a patient with previous uneventful surgeries under regional anesthesia

Makkar, Jeetinder Kaur; Jain, Divya; Jain, Kajal; Pareek, Ashish

doi:10.4103/0970-9185.173338

Cited by 2 publications

(2 citation statements)

References 2 publications

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“…Alparslan et al [ 22 ] discussed a case of vasovagal syncope observed after administration of spinal anesthesia in the sitting position. Makkar et al [ 23 ] reported a case of vasovagal-mediated cardiac arrest in the sitting position during epidural catheter insertion. Keenan4et al [ 24 ] reported a case of postoperative vasovagal cardiac arrest in the post-anesthesia care unit.…”

Section: Discussionmentioning

confidence: 99%

“…The results indicated that inserting the epidural catheter in a sitting position was more beneficial for patient outcomes. Makkar et al [ 23 ] suggested that young and healthy patients with higher vagal tone are more prone to vasovagal episodes. Even without any local anesthetic administration, simply placing an epidural catheter can lead to severe bradycardia and cardiac arrest.…”

Section: Discussionmentioning

confidence: 99%

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Syncope Due to a Vasovagal Response for Drainage of Perianal Abscess Under Spinal Anesthesia: A Case Report

Ma¹,

Tian²,

Deng³

2023

Am J Case Rep

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Patient: Male, 44-year-old Final Diagnosis: Vasovagal syncope Symptoms: Syncope Clinical Procedure: Spinal anesthesia Specialty: Anesthesiology Objective: Unusual clinical course Background: Vasovagal syncope is a loss of consciousness caused by decreased arterial pressure and cerebral blood flow. The characteristic features of vasovagal syncope include cardiovascular inhibition caused by neural reflexes, accompanied by vasodilation and bradycardia. To date, there is little literature to report several episodes of syncope under spinal anesthesia during the perioperative period for drainage of an anal abscess. The purpose of this article is to alert clinical practitioners to the early identification of the underlying causes of vasovagal syncope and to facilitate timely and effective management strategies. Case Report: We present the case of a 44-year-old man with a perianal abscess who was scheduled for an incision and drainage procedure for the abscess under spinal anesthesia. Preoperative assessment revealed no history of cardiac disease, neurological disorders, or drug allergies. During the perioperative period, the patient experienced 3 episodes of syncope: 1 episode during puncture of spinal anesthesia, and the others at 6.5 h and 8.5 h after the procedure. The patient was discharged 4 days later, and a 30-day postoperative follow-up showed good recovery, without any episodes of syncope. Conclusions: We described a case of 3 episodes of vasovagal syncope occurring in a patient during the perioperative period of drainage of perianal abscess under spinal anesthesia. Pain may have been the main cause of vasovagal syncope in this patient. To avoid vasovagal syncope, it is best for anesthesiologists to choose the lateral position to perform spinal anesthesia and to provide good perioperative pain management for these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Syncope Due to a Vasovagal Response for Drainage of Perianal Abscess Under Spinal Anesthesia: A Case Report

Ma¹,

Tian²,

Deng³

2023

Am J Case Rep

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A Case of Cardiac Arrest Caused by Vasovagal Reflex during Blepharoplasty under Local Anesthesia

Fujita¹,

Kondoh²,

Sakai³

et al. 2023

JPRS

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Vasovagal reflex may cause benign self-limiting syncope triggered by factors such as pain and emotional stress. However, rarely, it may cause cardiac arrest requiring urgent resuscitation, which has heretofore not been reported during blepharoplasty. In this report, the case of a 28-year-old man who underwent blepharoplasty under local anesthesia is presented. He suddenly experienced bradycardia and subsequent cardiac arrest during resection of the orbicularis oculi. He was fearful after smelling the unpleasant odor of burned tissue and fainted. He recovered consciousness within 1 min following prompt chest compression. Based on intraoperative conditions and cardiological examinations, vasovagal reflex was considered to be the cause of the cardiac arrest. Blepharoplasty involves multiple factors that can lead to neurocardiogenic syncope, thus increasing the risk for intraoperative syncope and circulatory collapse. Hence, the procedure should be performed under close monitoring with the preparation of staff, intravenous access, drugs, and resuscitation cart to manage possible cardiac arrest.

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Vasovagal mediated cardiac arrest during epidural catheter insertion in a patient with previous uneventful surgeries under regional anesthesia

Cited by 2 publications

References 2 publications

Syncope Due to a Vasovagal Response for Drainage of Perianal Abscess Under Spinal Anesthesia: A Case Report

Syncope Due to a Vasovagal Response for Drainage of Perianal Abscess Under Spinal Anesthesia: A Case Report

A Case of Cardiac Arrest Caused by Vasovagal Reflex during Blepharoplasty under Local Anesthesia

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