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Yin F, Zhang TJ. Cardiac arrest by rhino-cardiac reflex during nasotracheal intubation. Asian J Surg 2022:S1015-9584(22)01718-3. [PMID: 36509599 DOI: 10.1016/j.asjsur.2022.11.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022] Open
Affiliation(s)
- Fang Yin
- Department of Anesthesiology and the State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology, Wuhan University, Luoyu Street 237, Wuhan, 430079, China
| | - Tie-Jun Zhang
- Department of Anesthesiology and the State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology, Wuhan University, Luoyu Street 237, Wuhan, 430079, China.
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Bloom WR, Bloom TD. Neurally Mediated Syncope Triggered by COVID-19 Nasopharyngeal Swab Specimen Collection: A Case Report. ALLERGY & RHINOLOGY 2022; 13:21526567211073794. [PMID: 35096463 PMCID: PMC8796065 DOI: 10.1177/21526567211073794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There are few reports describing adverse events associated with nasopharyngeal swab specimen collection in patients tested for SARS-Cov-2 (COVID-19). Despite the lack of data, providers should be aware of complications associated with swab collection. Instances of nasopharyngeal swab as a syncope trigger are mostly anecdotal and not well described in the medical literature. We present a case of neural reflex mediated syncope associated with the nasopharyngeal swab specimen collection process in a healthy patient undergoing COVID-19 testing prior to elective surgery. This response may be mediated by the trigeminocardiac reflex or via glossopharyngeal nerve stimulation. Less invasive collection practices, such as saliva sampling, may be warranted, particularly in those predisposed to syncopal episodes.
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Affiliation(s)
- William R. Bloom
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
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