Taiwanese Journal of Obstetrics and Gynecology
Volume 45, Issue 3 , Pages 208-214 , September 2006

Perioperative Vasovagal Syncope with Focus on Obstetric Anesthesia

  • Pei-Shan Tsai

      Affiliations

    • Department of Anesthesiology, Hsinchu Mackay Memorial Hospital, Hsinchu, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Pei-Shan Tsai, Department of Anesthesiology, Hsinchu Mackay Memorial Hospital, 690, Section 2, Guangfu Road, Hsinchu 300, Taiwan
    • ,
  • Chih-Ping Chen

      Affiliations

    • Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
    • ,
  • Ming-Song Tsai

      Affiliations

    • Prenatal Diagnosis Center, Cathay General Hospital, Taipei, Taiwan

,Accepted 9 March 2006.

References 

  1. Shen WK , Gersh BJ . Fainting: approach to management . In:  Low PA editors. Clinical Autonomic Disorders: Evaluation and Management . 2nd edition. Philadelphia: Lippincott-Raven; 1997;p. 649–679
  2. Kapoor WN . Syncope . N Engl J Med . 2000;343:1856–1862
  3. Kinsella SM , Tuckey JP . Perioperative bradycardia and asystole: relationship to vasovagal syncope and Bezold-Jarisch reflex . Br J Anaesth . 2001;86:859–868
  4. Matsukawa K , Shindo T , Shirai M , Ninomiya I . Nitric oxide mediates cat hindlimb cholinergic vasodilation induced by stimulation of posterior hypothalamus . Jpn J Physiol . 1993;43:473–483
  5. Fenton AM , Hammill SC , Rea RF , Low PA , Shen WK . Vasovagal syncope . Ann Intern Med . 2000;133:714–725
  6. Dietz NM , Halliwill JR , Spielmann JM , et al.   Sympathetic withdrawal and forearm vasodilation during vasovagal syncope in humans . J Appl Physiol . 1997;82:1785–1793
  7. Shastry S , Dietz NM , Halliwill JR , Reed AS , Joyner MJ . Effects of nitric oxide synthase inhibition on cutaneous vasodilation during body heating in humans . J Appl Physiol . 1998;85:830–834
  8. Miller RD . In: Anesthesia . 5th edition. Philadelphia: Chuchill Livingstone; 2000;p. 739
  9. Grimm DR . Neurally mediated syncope: a review of cardiac and arterial receptors . J Clin Neurophysiol . 1997;14:170–182
  10. Caplan RA , Ward RJ , Posner K , Cheney FW . Unexpected cardiac arrest during spinal anesthesia: a close claims analysis of predisposing factors . Anesthesiology . 1998;68:5–11
  11. Morillo CA , Ellenbogen KA , Pava LF . Pathophysiologic basis for vasodepressor syncope . Syncope . 1997;15:233–249
  12. Van Lieshout JJ , Wieling W , Karemaker JM , Eckberg DL . The vasovagal response . Clin Sci . 1991;81:575–586
  13. Van Lieshout JJ , Wieling W , Karemaker JM . Neural circulatory control in vasovagal syncope . Pacing Clin Electrophysiol . 1997;20:753–763
  14. McMichael J . Clinical aspects of shock . J Am Med Assoc . 1944;124:275–281
  15. Barcroft H , Edholm OG , McMichael J , Sharpey-Schafer EP . Post hemorrhagic fainting. Study by cardiac output and forearm flow . Lancet . 1944;1:489–491
  16. Bonica JJ , Kennedy WF , Akamatsu TJ , Gerbershagen HU . Circulatory effects of peridural block: III. Effects of acute blood loss . Anesthesiology . 1972;36:219–227
  17. El-Sayed H , Hainsworth R . Relationship between plasma volume, carotid baroreceptor sensitivity and orthostatic tolerance . Clin Sci . 1995;88:463–470
  18. Hansen R . Ohnmacht and Schwangerschaft . Klin Wochenschr . 1942;21:241–245
  19. Kinsella SM , Lohmann G . Supine hypotensive syndrome . Obstet Gynecol . 1994;83:774–788
  20. Lees MM , Scott DB , Kerr MG , Taylor SH . The circulatory effects of recumbent postural change in late pregnancy . Clin Sci . 1967;32:453–465
  21. Hart PS , Yanny W . Needle phobia and malignant vasovagal syndrome . Anaesthesia . 1998;53:1002–1004
  22. Hampl KF , Schneider MC . Vasovagal asystole before induction of general anesthesia . Eur J Anaesth . 1994;11:131–133
  23. Keane TK , Hennis PJ , Bink-Boelkens MTE . Non-drug related asystole associated with anaesthetic induction . Anaesthesia . 1991;46:38–39
  24. Mimura T, Funatsu H, Yamagami S, Usui T, Ono K, Araie M, et al. Vasovagal syncope evoked by needle phobia when inserting a contact lens . Ophthalmic Physiol Opt . 2005;25:171–173
  25. Chan SK , Karmakar MK , Chui PT . Local anesthesia outside the operating room . HKMJ . 2002;8:106–113
  26. Khurana RK . Eye examination-induced syncope role of trigeminal afferents . Clin Auton Res . 2002;12:399–403
  27. Sharpey-Schafer EP . Syncope . Br Med J . 1956;3:506–509
  28. McConachie I . Vasovagal asystole during spinal anesthesia . Anaesthesia . 1991;46:281–282
  29. Sprung J , Abdelmalak B , Schoenwald PK . Vasovagal cardiac arrest during the insertion of an epidural catheter and before the administration of epidural medication . Anesth Analg . 1998;86:1263–1265
  30. Carpenter RL , Caplan RA , Brown DL , Stephenson C , Wu R . Incidence and risk factors for side effects of spinal anesthesia . Anesthesiology . 1992;76:906–916
  31. Tarkkila P , Isola J . A regression model for identifying patients at high risk of hypotension, bradycardia, and nausea during spinal anesthesia . Acta Anaesthesiol Scand . 1992;36:554–558
  32. Peters J , Kutkuhn B , Medert HA , Schlaghecke R , Schuttler J , Arndt JO . Sympathetic blockade by epidural anesthesia attenuates the cardiovascular response to severe hypoxemia . Anesthesiology . 1990;72:134–144
  33. Rosenberg JM , Wahr JA , Sung CH , Oh YS , Gilligan LJ . Coronary perfusion pressure during cardiopulmonary resuscitation after spinal anesthesia in dogs . Anesth Analg . 1996;82:84–87
  34. Geffin B , Shapiro L . Sinus bradycardia and asystole during spinal and epidural anesthesia: a report of 13 cases . J Clin Anesth . 1998;10:278–285
  35. Liguori GA , Sharrock NE . Asystole and severe bradycardia during epidural anesthesia in orthopedic patients . Anesthesiology . 1997;86:250–257
  36. Almquist A , Goldenberg IF , Milstein S , et al.   Provocation of bradycardia and hypotension by isoproterenol and upright posture in patients with unexplained syncope . New Engl J Med . 1989;320:346–351
  37. Wasserstrum N . Nitroprusside in preeclampsia. Circulatory distress and paradoxical bradycardia . Hypertension . 1991;18:79–84
  38. Nolan TE , Hankins GD . Myocardial infarction in pregnancy . Clin Obstet Gynecol . 1989;32:68
  39. Norris MC . In: Obstetric Anesthesia . 2nd edition. Philadelphia: Lippincott Williams & Wilkins; 1999;p. 30
  40. Holmes F . Spinal analgesia and caesarean section. Maternal mortality . J Obstet Gynaecol Br Emp . 1957;64:229–232
  41. Holmes F . The supine hypotensive syndrome. Its importance to the anesthetist . Anaesthesia . 1960;15:298–306
  42. Morgan GE , Mikhail MS , Murray MJ . In: Clinical Anesthesiology . 3rd edition. New York: McGraw-Hill; 2002;p. 830
  43. Thomas C . The incidence and risk factors for cardiac arrest during emergency tracheal intubation: a justification for incorporating the ASA guidelines in the remote location . J Clin Anesth . 2004;16:508–516
  44. Hashiba M , Okutomi T , Saito K , Amano K , Okamoto H , Hoka S . A case of cardiac arrest at induction of anesthesia for postpartum hysterectomy . Masui . 2002;51:1355–1358
  45. Ruiz K . Asystole on induction . Anaesthesia . 1989;44:698–699
  46. Stienstra R , Veering BT . Intrathecal drug spread: is it controllable? . Reg Anesth Pain Med . 1998;23:347–351
  47. Nishikawa T , Anzai Y , Namiki A . Asystole during spinal anesthesia after change from Trendelenburg to horizontal position . Can J Anaesth . 1988;35:406–408
  48. Green NM , Brull SJ . Physiology of Spinal Anesthesia . 4th edition. Baltimore, MD: Williams & Wilkins; 1994;
  49. Mackey DC , Carpenter RL , Thompson GE , Brown DL , Bodily MN . Bradycardia and asystole during spinal anesthesia: a report of three cases without morbidity . Anesthesiology . 1989;70:866–868
  50. Lewis T . Vasovagal syncope and the carotid sinus mechanism with comments on Gowers's and Nothnagel's syndrome . Br Med J . 1932;1:873–876
  51. Connolly SJ , Sheldon R , Thorpe KE , et al.   Pacemaker therapy for prevention of syncope in patients with recurrent severe vasovagal syncope: second vasovagal pacemaker study (VPS II): a randomized trial . JAMA . 2003;289:2224–2229
  52. Brown DL , Carpenter RL , Moore DC , et al.   Cardiac arrest during spinal anesthesia . Anesthesiology . 1988;68:971–972

PII: S1028-4559(09)60226-6

doi: 10.1016/S1028-4559(09)60226-6

Taiwanese Journal of Obstetrics and Gynecology
Volume 45, Issue 3 , Pages 208-214 , September 2006

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