Gaseous induction of anesthesia with sevoflurane may be an effective strategy to avoid vasovagal responses during intravenous access in patients with needle phobia and malignant vasovagal syndrome.
May support sevoflurane gaseous induction to avoid vasovagal syncope; hypothesis-generating case leaves efficacy and generalizability open.
A case is reported in which suspicion of malignant vasovagal syndrome was aroused by a history of faints and needle phobia. The vasovagal response was successfully avoided using a gaseous induction of anaesthesia with sevoflurane. Intravenous access was achieved under general anaesthesia. The diagnosis of malignant vasovagal syndrome was confirmed postoperatively using a head-up tilt table test. An outline of the pathophysiology of the syndrome gives some indication for suitable anaesthetic management strategies in similar cases.
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Hart et al. (1998) studied this question.
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