Editorial Type:
Article Category: Brief Report
 | 
Online Publication Date: Mar 28, 2023

Lidocaine Tape Application for 3 Hours Prevents Vasovagal Syncope During Venipuncture: A Case Series

DDS,
DDS, PhD,
DDS,
DDS, PhD, and
DDS, PhD
Page Range: 34 – 36
DOI: 10.2344/anpr-70-01-03
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Vasovagal syncope (VVS) or reflex is usually caused by physical and mental stress-related factors, like pain, anxiety, and fear, and it is one of the most frequent complications during dental treatment. Two patients, both with histories of dental phobia and of VVS during vaccination, venipuncture, and dental treatment with local anesthetics, were scheduled for dental treatment under intravenous (IV) sedation. However, both experienced episodes of VVS that occurred during venipuncture using a 24-gauge indwelling needle. We determined that pain was the main trigger of VVS for these patients and attempted to reduce venipuncture-associated pain using 60% lidocaine tape applied 3 hours before venipuncture at their next dental visits, respectively. Use of the lidocaine tape was successful and permitted comfortable placement of the IV catheter without any onset of VVS.

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Copyright: © 2023 by the American Dental Society of Anesthesiology
Figure 1.
Figure 1.

ECG Tracings Captured During VVS

ECG recorded (a) before IV start, (b) during VVS episode, and (c) after recovery. In Case 1, sinus arrest was observed for ∼12.7 seconds before the occurrence of escape rhythms (arrows). In Case 2, sinus arrest was observed for ∼3.4 seconds. ECG, electrocardiogram; VVS, vasovagal syncope.


Figure 2.
Figure 2.

60% Lidocaine Tape on Venipuncture Site

Patients were directed to self-apply lidocaine tape containing 18 mg of lidocaine at the previously identified venipuncture site 3 hours prior to venipuncture.


Contributor Notes

Address correspondence to Dr Takashi Goto, Department of Dental Anesthesiology, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, 1851-1 Hozumi, Mizuho-shi, Gifu, Japan, 501-0223; takashigoto@dent.asahi-u.ac.jp.
Received: Mar 14, 2022
Accepted: May 21, 2022