[Psychological aspects of spinal anesthesia. Vasovagal syncope and anxiolytic medication]

In 61 male and female patients, the influence of the preoperative emotional state on vasovagal syncopes and anxiolytic medication during spinal anaesthesia for elective orthopaedic surgery was investigated. Male patients pretended to feel emotionally better than female patients, but had higher rates of anxiolytic medication and vasovagal syncopes. Patients in a bad (n = 8) and in a good emotional state (n = 3) received more anxiolytic medication than those with a mean emotional state. Vasovagal syncopes were registered in patients who pretended to feel good (n = 6), in those who felt bad (n = 4) and only in one patient of the mean group. The factors anxiety and depression were the most responsible for this result. The importance of coping-mechanisms for the development of psychological and psychophysiological reactions is discussed. Vasovagal syncope is interpreted as a psychophysiological reaction. In consequence it needs psychoprophylaxis.