Risk Factors for Vasovagal Reactions during Nonoperative Orthopedic Interventions in Outpatient Clinics: A Clinical...

Vasovagal reactions (VVRs) are abnormal autonomic responses mediated by the vagus nerve. They can occur during or after interventional procedures and negatively impact patient care. The aim of this study was to evaluate the incidence of VVRs observed during nonoperative orthopedic interventions in outpatient clinics and to analyze the associated risk factors.

The data of 1,208 patients who underwent nonoperative orthopedic interventions at a single-center outpatient clinic between December 2023 and December 2024 were retrospectively analyzed. Patients were categorized into 2 groups based on the occurrence of VVR. The clinical data of both groups were analyzed to identify factors associated with VVRs.

A total of 1,208 patients with a mean age of 54.7 years were included in the study. Among the 1,208 patients included, 51 cases of VVRs were reported (4.2%). The VVR group had a younger mean age (44.2 vs. 55.1 years, p < 0.001) and a higher proportion of females (74.5% vs. 59.2%, p = 0.029) compared to the non-VVR group. Mean visual analog scale (VAS) scores during intervention were higher in the VVR group (6.41 vs. 2.98, p < 0.001), and blood-injury-injection (BII) phobia was more common (39.2% vs. 1.8%, p < 0.001). Fasting time was longer in the VVR group (3.9 vs. 2.8 hours, p = 0.003). No significant differences were observed in hypertension, coronary artery disease, cerebrovascular disease, or asthma between groups (p > 0.05).

Younger age, female sex, higher VAS scores, BII phobia, and longer fasting times were the risk factors for VVRs associated with nonoperative orthopedic interventions.