Perioperative Vasovagal Syncope with Focus on Obstetric Anesthesia
Vasovagal syncope refers to a reflex cardiovascular depression that gives rise to loss of consciousness with bradycardia and profound vasodilatation. This response commonly occurs during regional anesthesia, hemorrhage or supine inferior vena cava compression in pregnancy. The changes in circulatory...
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| Format: | Article |
| Language: | English |
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Elsevier
2006-09-01
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| Series: | Taiwanese Journal of Obstetrics & Gynecology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1028455909602266 |
| _version_ | 1811326499197812736 |
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| author | Pei-Shan Tsai Chih-Ping Chen Ming-Song Tsai |
| author_facet | Pei-Shan Tsai Chih-Ping Chen Ming-Song Tsai |
| author_sort | Pei-Shan Tsai |
| collection | DOAJ |
| description | Vasovagal syncope refers to a reflex cardiovascular depression that gives rise to loss of consciousness with bradycardia and profound vasodilatation. This response commonly occurs during regional anesthesia, hemorrhage or supine inferior vena cava compression in pregnancy. The changes in circulatory response from the normal maintenance of arterial pressure to parasympathetic activation and sympathetic inhibition may cause severe hypotension. This change is triggered by reduced cardiac venous return as well as episodes of emotional stress, excitement or pain. Occasionally, these vasovagal responses may be unpredictable and may dramatically proceed to asystole with circulatory collapse, and may even result in death. In these circumstances, hypotension may be more severe than that caused by bradycardia alone, because of unappreciated vasodilatation. Regional anesthesia, decreased venous return, hemorrhage and abnormal fetal presentation cumulatively increase the risk of vasovagal syncope in cesarean section patients. When a vasovagal response occurs, ephedrine is the drug of first choice because of its combined action on the heart and peripheral blood vessels. Epinephrine must be used early in established cardiac arrest, especially after high regional anesthesia. |
| first_indexed | 2024-04-13T14:50:20Z |
| format | Article |
| id | doaj.art-1081c56d3a7d4d73879b04cc5e3c9fce |
| institution | Directory Open Access Journal |
| issn | 1028-4559 |
| language | English |
| last_indexed | 2024-04-13T14:50:20Z |
| publishDate | 2006-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Taiwanese Journal of Obstetrics & Gynecology |
| spelling | doaj.art-1081c56d3a7d4d73879b04cc5e3c9fce2022-12-22T02:42:36ZengElsevierTaiwanese Journal of Obstetrics & Gynecology1028-45592006-09-0145320821410.1016/S1028-4559(09)60226-6Perioperative Vasovagal Syncope with Focus on Obstetric AnesthesiaPei-Shan Tsai0Chih-Ping Chen1Ming-Song Tsai2Department of Anesthesiology, Hsinchu Mackay Memorial Hospital, Hsinchu, TaiwanDepartment of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, TaiwanPrenatal Diagnosis Center, Cathay General Hospital, Taipei, TaiwanVasovagal syncope refers to a reflex cardiovascular depression that gives rise to loss of consciousness with bradycardia and profound vasodilatation. This response commonly occurs during regional anesthesia, hemorrhage or supine inferior vena cava compression in pregnancy. The changes in circulatory response from the normal maintenance of arterial pressure to parasympathetic activation and sympathetic inhibition may cause severe hypotension. This change is triggered by reduced cardiac venous return as well as episodes of emotional stress, excitement or pain. Occasionally, these vasovagal responses may be unpredictable and may dramatically proceed to asystole with circulatory collapse, and may even result in death. In these circumstances, hypotension may be more severe than that caused by bradycardia alone, because of unappreciated vasodilatation. Regional anesthesia, decreased venous return, hemorrhage and abnormal fetal presentation cumulatively increase the risk of vasovagal syncope in cesarean section patients. When a vasovagal response occurs, ephedrine is the drug of first choice because of its combined action on the heart and peripheral blood vessels. Epinephrine must be used early in established cardiac arrest, especially after high regional anesthesia.http://www.sciencedirect.com/science/article/pii/S1028455909602266anesthesiaasystolebradycardiahemorrhagevasovagal syncope |
| spellingShingle | Pei-Shan Tsai Chih-Ping Chen Ming-Song Tsai Perioperative Vasovagal Syncope with Focus on Obstetric Anesthesia Taiwanese Journal of Obstetrics & Gynecology anesthesia asystole bradycardia hemorrhage vasovagal syncope |
| title | Perioperative Vasovagal Syncope with Focus on Obstetric Anesthesia |
| title_full | Perioperative Vasovagal Syncope with Focus on Obstetric Anesthesia |
| title_fullStr | Perioperative Vasovagal Syncope with Focus on Obstetric Anesthesia |
| title_full_unstemmed | Perioperative Vasovagal Syncope with Focus on Obstetric Anesthesia |
| title_short | Perioperative Vasovagal Syncope with Focus on Obstetric Anesthesia |
| title_sort | perioperative vasovagal syncope with focus on obstetric anesthesia |
| topic | anesthesia asystole bradycardia hemorrhage vasovagal syncope |
| url | http://www.sciencedirect.com/science/article/pii/S1028455909602266 |
| work_keys_str_mv | AT peishantsai perioperativevasovagalsyncopewithfocusonobstetricanesthesia AT chihpingchen perioperativevasovagalsyncopewithfocusonobstetricanesthesia AT mingsongtsai perioperativevasovagalsyncopewithfocusonobstetricanesthesia |