61 Vasovagal syncope related to pain procedures in a pain clinic at a tertiary Lebanese hospital between 2016 and 2019

Background and Aims A vasovagal reaction is a common cardiovascular complication that can occur during an interventional procedure. Our study focuses on evaluating the factors associated with vasovagal syncope (VVS) when having a pain procedure at the pain clinic as well as showing variation in vital signs associated with fainting across different periods of the procedure(before, during and after). Methods A retrospective case control study was conducted in a university hospital in Lebanon (CHU-NDS) on adult Lebanese patients with data taken from the archives covering a 4 year period (2016–2019). It included 188 patients: 94 cases representing all the ones who had endured a VVS or presyncope related to a pain procedure during this timeframe and 94 controls with matching demographic features. Results The multivariable analysis showed that a higher systolic blood pressure per-procedure was significantly associated with lower odds of having vasovagal syncope. An adequate dose of a vasopressor like ephedrine can be used to prevent a vasovagal event from happening. In our study the blood pressure component was more significant than the heart rate component which stayed in the normal range limit in the three different periods of the procedure. Cases having a pain procedure for the first time represent 59.6% of the occurrence of VVS. Conclusions Enduring an interventional procedure combines both physiological and psychological challenges. Our study suggests taking preventive measures for patients with first time infiltration status especially if appearing in an anxious state.