FactFinders for patient safety: Preventing potential procedure-related complications: Vasovagal reactions and spinal cord stimulator lead migration

Abstract

This series of FactFinders presents a brief summary of the evidence and outlines recommendations to improve our understanding and management of several potential procedure-related complications. Evidence in support of the following facts is presented. (1) Vasovagal Reactions During Interventional Pain Procedures -- The overall incidence of vasovagal reactions (VVR) ranges from 1 to 8% during interventional pain procedures, though certain patient populations may be at greater risk. Younger age, male sex, and a history of a VVR are associated with an increased likelihood of VVR. In select patients, moderate sedation may be considered for prevention of a repeat vasovagal reaction. (2) Spinal Cord Stimulator Trial Lead Migration -- Suturing percutaneous SCS leads does not mitigate the risk of migration compared to taping alone during a trial. Most lead migration does not pose a safety concern during the trial period.