Incidence and influencing factors of vasovagal reaction in computed tomography (CT)-guided localisation of pulmonary ground-glass nodules prior to video-assisted thoracoscopic surgery.

AIM: To investigate the incidence, clinical features, and influencing factors of vasovagal reaction (VVR) associated with computed tomography (CT)-guided localisation of pulmonary ground-glass nodules (GGNs) prior to video-assisted thoracoscopic surgery (VATS).

MATERIALS AND

METHODS

A total of 1303 consecutive patients who underwent CT-guided localisation of GGNs were selected as research subjects. VVR related to CT-guided localisation was defined as the onset of otherwise unexplained transient hypotension and/or relative bradycardia during or after localisation, manifesting as symptoms such as pallor, sweating, nausea, and potentially syncope. Risk factors for VVR were identified through both univariate and multivariate analyses.

RESULTS

VVR was observed in 4.5% (58/1,303) of the patients. All VVRs occurred postlocalisation, with 91.4% (53/58) happening between the time patients rose from the CT table and their departure from the CT room. Prodromal symptoms were evident in all VVR cases, with two cases progressing to syncope, each with a brief loss of consciousness lasting less than one minute. Univariate analysis identified significant risk factors for VVR, including patient age, stress level, history of syncope, and the marking of multiple GGNs, as well as marking time. Multivariate logistic regression analysis revealed that patient stress (odds ratio [OR], 20.17; P < 0.001) and a history of syncope (OR, 8.06; P = 0.002) were independent risk factors for VVR.

CONCLUSION

VVR affects approximately 4.5% of patients undergoing CT-guided localisation of GGNs, often manifesting immediately after rising from the CT table. Patient stress and a history of syncope are significantly associated with an increased likelihood of VVR.