Anästhesie und klinische Forschung
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Vasovagal Attack during Insertion of Thoracic Paravertebral Catheter: A known but Rarely Reported Incident

Shilpi Agarwal, Sachidanand Jee Bharti and Wasimul Hoda

Vasovagal syncope is defined as a sudden and transient loss of consciousness. We report a case of vasovagal attack during insertion of thoracic paravertebral cathether. A 28 year old male ASA I, case of bronchus Schwannomas was posted for left sided Pneumonectomy. Past history of 2 episodes of dizziness and fainting on visualization of blood. During insertion of the catheter through the needle, patient felt paraesthesia and complained of giddiness and became unconscious. The monitor showed sudden bradycardia and hypotension. The blood glucose was found to be 55 mg/dl. 25% dextrose 100 ml was given to correct hypoglycemia. Patient was resuscitated and surgery completed. Therefore, Vasovagal episodes along with regional anesthesia can be a significant hazard. Attention must be given to patients with history of vasovagal episodes. Adequate comfortable positioning, reassurance, adequate sedatives to relieve anxiety and preprocedure optimization of blood glucose may be useful in such patients.