• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.3
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• pp.151-155
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• 2012

A vasovagal reaction is defined as the 'development of hypotension and bradycardia associated with the typical clinical manifestations of pallor, sweating and weakness'. The most profound degree of vasovagal reaction results in fainting or syncope. Incidence of vasovagal reactions in the local anesthetic department of a dental hospital is around 2%. The pathophysiology of the hypotension/bradycardia reflex responsible for vasovagal syncope is not completely understood. Central as well as peripheral mechanisms have been implicated in its pathogenesis: however their relative contribution is not fully elucidated. Recently, trigeminocardiac reflex, previously known as oculocardiac reflex, may serve as syncope. The management of vasovagal syncope is evolving. Non-pharmacological treatment options are a fundamental first step of all treatment pathways. In this article, we would like to review new mechanism of vasovagal syncope and hope to be of help to manage the syncopal patients.

• Korean Journal of Acupuncture
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• v.40 no.4
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• pp.206-211
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• 2023

Objectives : Needle sickness is one of the adverse events of acupuncture, although substantial adverse effects during a routine acupuncture treatment seem to be highly unusual. In this work, we propose that an acupuncture-related vasovagal response resembles needle sickness during acupuncture therapy. Methods : In this article, we discussed the general characteristics of vasovagal syncope and went into more detail on vasovagal syncope in people who have a fear of blood injection and injury. We also offer a recommendation for the prevention and management of vasovagal syncope brought on by acupuncture. Results : The vasovagal reaction related to acupuncture is closely associated with needle sickness. The prevention can be done using PEACHES (position, experience, anxiety, constitution, hydration, environment, symptom recognition) principles. The management should be conducted using the RIPCORD (recognize, initiate, position, communicate, order treatments, reassess, document) techniques. Conclusions : It is important to comprehend the characteristics of needle sickness as a vasovagal reaction related to acupuncture. According to the recommendation, practitioners should effectively prevent and manage needle sickness.

• Journal of The Korean Dental Society of Anesthesiology
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• v.11 no.2
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• pp.159-163
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• 2011

Vasovagal syncope accounts for the majority of adverse events that occur in dental offices and is normally related to emotional or somatic factors. The factors trigger intense parasympathetic state, leading to bradycardia and hypotension. We experienced a case of vasovagal syncope just before general anesthesia. A 49-year-old woman with alveolar bone deficiency on maxilla and mandible was planned to undergo an alveolar bone graft with mandibular body under general anesthesia. She didn't have any histories of disease, medication or syncope. Though she showed a little anxiety from admission, she had no pre-operative medication. After she was guided to the operating room, she had signs and symptoms of vasovagal syncope without any prodromes. The patient was resuscitated soon only by the conservative treatment and was operated under general anesthesia.

• 대한상한금궤의학회지
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• v.12 no.1
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• pp.81-89
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• 2020

Objective: This case report presents the effect of Oryeong-san on vasovagal syncope. The patient was diagnosed with Grater Yang disease based on Shanghanlun provisions. Methods: According to the disease pattern identification diagnostic system based on Shanghanlun provisions (DPIDS), we diagnosed the patient as presenting Greater Yang disease. The patient was treated with Oryeong-san for 45 days. The change in symptoms was estimated based on VAS. Results: After treatment, the patient's VAS score from 10 to 0 and he was completely cured. Conclusions: This case study shows the effectiveness of using Oryeong-san on vasovagal syncope according to DPIDS.

• The Journal of Internal Korean Medicine
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• v.38 no.2
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• pp.240-245
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• 2017

Objectives: The purpose of this clinical case report is to describe the efficacy of Korean medicine in the treatment of vasovagal syncope. Methods: The patient was treated with acupuncture, pharmacopuncture, and herbal medicine. The symptoms (headache, palpitation, sweating, flushing, weakness, coldness) of the patient were observed. Results: After the treatment, the patient's symptoms improved, but more treatments were required. Conclusion: This study can add to understanding of the effect of Korean medicine on vasovagal syncope.

• Proceedings of the IEEK Conference
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• 1998.06a
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• pp.561-564
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• 1998

This paper evaluated autonomic nervous system function in 23 patients with syncope and a positive tilt test result, 21 with a negative test result, and 19 healthy controls. Indexes of heart rate variability were measured during supine resting, immediately afte rtilt-up, standing rsting, immediately before syncope and immediately after tiltdown. There were no significant differences among the groups in any of the indexes of heart rate varability over the 24-hour holter recordings. In patients with a positive tilt result, tilting gaused a decrease in low-frequency (LF) immediately before syncope and incsrease in high-frequency (HF) bands immediately before. In patients with a negative tilt result, tilting caused a decrease in low-frequency (LF) immediately before syncope and decrease in high-frequency (HF) bands immediately before, different from positive tilt results. Our findings showed that patients with vasovagal syncope have no chronic differences from normal subjects in autonomic nervous system activity, but that these patients respond differently to the orthostatic stimulus.

• Clinical and Experimental Pediatrics
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• v.65 no.1
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• pp.47-52
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• 2022

Background: An adequate large-scale pediatric cohort based on nationwide administrative data is lacking in Korea. Purpose: This study aimed to differentiate patients with VVS by autonomic dysfunction severity using the composite autonomic severity score (CASS) and compare the clinical manifestations and prognosis between patient subgroups. Methods: We retrospectively reviewed the medical records of 66 VVS patients divided into 3 groups by CASS. To compare the differences between these groups, we analyzed VVS type, triggers, prodromal symptoms, management of syncope, and prognosis between patients with mild versus moderate autonomic dysfunction. Results: Of our 66 patients with VVS, 41 had mild autonomic dysfunction (62.1%) and 25 had moderate autonomic dysfunction (37.9%). We found no significant intergroup differences in age, sex, inducible factor (P=0.172), prodromal symptoms, laboratory findings, head-up tilt test, type of syncope, or prognosis (P=0.154). Conclusion: We found no evidence that autonomic dysfunction degree is affected by VVS characteristics, test findings, parameters, or prognosis; therefore, no further evaluations are needed to classify autonomic dysfunction severity.

• Clinical and Experimental Pediatrics
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• v.46 no.10
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• pp.983-988
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• 2003

Purpose : Syncope appears to be common. However, the mechanism of syncope is not clear. Increased vagal activity and withdrawal of sympathetic stimulation cause hypotension, bradycardia and finally loss of consciousness. The purpose of this study was to evaluate changes of cerebral blood flow velocity, blood pressure, and heart rate during tilt test in children with vasovagal syncope. Methods : Sixty four children with a past history of syncope were evaluated. The stand up test was performed for 15 minutes after a rest at supine position for 10 minutes, followed by an $80^{\circ}$ tilt test lasting 45 minutes. If presyncope(lightheadedness, nausea, blurred vision, or sweating) or syncope occurred, the study was discontinued. 12-lead electrocardiography, echocardiography, and electroencephalography were performed. Transcranial Doppler study was performed at the middle cerebral artery with 2 MHz continuous Doppler probe in 10 children with positive tilt test. Systolic, diastolic, mean cerebral blood flow velocity, integral, and pulsatility index were measured with blood pressure, heart rate, and $O_2$ saturation. Results : The positive rate of tilt test was 31.3%(20/64). Systolic, diastolic, and mean cerebral blood flow velocity decreased significantly in absence of hypotension or bradycardia during presyncope. Time velocity integral of cerebral artery also decreased significantly. Conclusion : Decreased cerebral blood flow velocity can predict the presyncope manifestation. Impairment of autoregulation of cerebral blood flow might play an important role in the pathophysiology of vasovagal syncope.

• Proceedings of the KIEE Conference
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• 2000.11d
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• pp.854-856
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• 2000

In this paper, complex demodulation method to access the dynamic autonomic nervous system characteristic of patients with syncope is proposed. Assessment of heart rate variability using conventional power spectral analysis such as FFT or AR-modeling could not capture a split change occurrence. However, in this paper, these changes are seen and by using Complex Demodulation Method(CDM) autonomic nervous system function assessments of patients with vasovagal syncope were verified and suggested.

• Proceedings of the KIEE Conference
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• 1999.11c
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• pp.624-1-624-3
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• 1999

In this paper, complex demodulation method to access the dynamic autonomic nervous system characteristic of patients with syncope is proposed. Assessment of heart rate variability using conventional power spectral analysis such as FFT or AR-modeling could not capture a split change occurrence. However, in this paper, these changes are seen and by using Complex Demodulation Method(CDM) autonomic nervous system function assessments of patients with vasovagal syncope were verified and suggested.