Leg Crossing as a Preventive Intervention to Manage Vasovagal Syncope

To handle medical emergencies, oral surgeons and dentists must have the necessary education and training.Atleast half of all medical emergencies in dental practice is syncope [1].Symptoms with transient loss of both conscious and postural tone is referred to as syncope.It occurs rapidly with quick recovery of the patient.Vasovagal Syncope (VVS) referred as “common faint” is neurally mediated illness that causes cerebral hypoperfusion,which results in hypotension and bradycardia [2].Vasovagal syncope occurs in about 2% of dental hospitals[3].The occurence is higher in young males than in females[4].According to literature ,from fields other than dentistry women are more likely to experience syncope[5-10].Any age group can experience vasovagal syncope .It has bimodal age distribution occuring higher between the ages of 20-29 yrs and 70-79 yrs [11].By using the patient's own words typical syncope features can be identified .34.3% of dentists have experienced vasovagal episode in their career [12].Most of the dentists and oral surgeons would have come across syncope in their careers[13,14].Psycological variables such as dental fear on seeing dental setting or treatment causes fear of going to the dentist in 10-15 % 0f population [15-17] .This helps to explain why dental practice experience has this common occurrence.From the patient's point of view oral surgical procedures which includes use of local anaesthesia can be emotionally challenging[18] .To treat syncope during extraction ,the patient is placed in supine posture with their feet raised at a 10 degree angle and airway is maintained open to establish cerebral perfusion [19].Conventionally ,leg raise and leg fold maneuvers can be used as simple and effective preventive maneuvers in patients with syncope and dental anxiety[20].The article's primary goal is to give a general overview of how to prevent vasovagal syncope in patient who have experienced anxiety or syncope in their past .It describes a physical maneuver that can be used during extraction to reduce the risk of developing vasovagal syncope.