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In‐office vasovagal response after rhinologic manipulation
Author(s) -
Radvansky Brian M.,
Husain Qasim,
Cherla Deepa V.,
Choudhry Osamah J.,
Eloy Jean Anderson
Publication year - 2013
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.21121
Subject(s) - medicine , emergency department , surgery , incidence (geometry) , retrospective cohort study , endoscopic sinus surgery , referral , physics , family medicine , psychiatry , optics
Background Advances in endoscopic sinus surgery have led to a greater number of in‐office procedures away from the traditional operating room setting. Rhinologists acting independently of anesthesiologists must be prepared for potential complications, such as vasovagal response (VVR), that may arise during in‐office rhinologic manipulations. In this study, we review our experience with this condition and discuss risk factors and a management algorithm for in‐office VVR. Methods A retrospective analysis at a large tertiary referral center was performed on all patients undergoing in‐office endoscopic procedures with rhinologic manipulation between July 2008 and June 2012. A total of 4973 patients underwent in‐office endoscopic procedures and 8 patients with VVR were identified. Demographic data, diagnosis, procedure performed, and outcomes were reviewed. Results Eight patients out of 4973 (0.16%) experienced VVR during in‐office endoscopic procedures. Seven (87.5%) of these 8 patients recovered from the VVR within 30 minutes and subsequently completed their scheduled procedure. One (12.5%) of the 8 patients did not fully recover after 30 minutes and was sent to the Emergency Department, where he was stabilized and subsequently discharged. The most common comorbidities in these 8 patients with VVR were hypercholesterolemia in 3 patients (37.5%), and hypertension and benign prostatic hyperplasia, each found in 2 patients (25.0%). Conclusion Although the incidence of VVR during rhinologic procedures is low, rhinologists should be familiar with this condition and be prepared for its management.