{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T08:58:58Z","timestamp":1781168338834,"version":"3.54.1"},"reference-count":0,"publisher":"Indian Orthopaedic Research Group","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Jocr"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:p>Introduction: Vasovagal syncope is a common reflex-mediated condition characterised by transient loss of consciousness due to autonomic imbalance resulting in hypotension and bradycardia. Although it is frequently encountered in response to pain or emotional stress, its occurrence during the perioperative period under regional anaesthesia is relatively uncommon but potentially alarming.\n\nCase Report: We report the case of a 39-year-old female with no significant comorbidities who presented with pain, swelling, instability, and locking of the right knee for 1.5 months. Magnetic resonance imaging revealed a posterior root tear of the medial meniscus, and she was scheduled for high tibial osteotomy with medial meniscus repair under neuraxial anaesthesia. During preparation for combined spinal\u2013epidural anaesthesia, the patient developed a vasovagal syncope episode following local anaesthetic infiltration. She was managed promptly with atropine, ephedrine, and supportive measures. After stabilisation, spinal anaesthesia with 0.5% hyperbaric bupivacaine and clonidine was administered successfully. The surgery lasted 3.5 h, and he remained haemodynamically stable intraoperatively. However, in the post-operative recovery room, the patient developed another vasovagal episode associated with severe pain, which responded to intravenous atropine. She recovered without further complications.\n\nConclusion: This case highlights the possibility of recurrent vasovagal syncope during the perioperative period triggered by pain and procedural stimuli. Awareness, prompt recognition, and early management are crucial to prevent serious complications.\n\nKeywords: Vasovagal syncope, spinal anesthesia, knee surgery, neuraxial anesthesia, perioperative complication.<\/jats:p>","DOI":"10.13107\/jocr.2026.v16.i06.7510","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T08:15:46Z","timestamp":1781165746000},"page":"468-471","source":"Crossref","is-referenced-by-count":0,"title":["Recurrent Vasovagal Syncope Triggered by Procedural Pain and Post-operative Analgesia during Spinal Anesthesia for High Tibial Osteotomy: A Case Report"],"prefix":"10.13107","volume":"16","author":[{"given":"Mansha","family":"Madan","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Punjab Institute of Medical Sciences and Research, Jalandhar, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravinder","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simarjot Singh","family":"Sodhi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Shree Ram Hospital, Jalandhar, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajal","family":"Maingi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Dayanand Medical College and Hospital, Ludhiana, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5271","published-online":{"date-parts":[[2026]]},"container-title":["Journal of Orthopaedic Case Reports"],"original-title":[],"deposited":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T08:15:48Z","timestamp":1781165748000},"score":1,"resource":{"primary":{"URL":"https:\/\/jocr.co.in\/wp\/2026\/06\/recurrent-vasovagal-syncope-triggered-by-procedural-pain-and-post-operative-analgesia-during-spinal-anesthesia-for-high-tibial-osteotomy-a-case-report\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":0,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026]]},"published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.13107\/jocr.2026.v16.i06.7510","relation":{},"ISSN":["2321-3817"],"issn-type":[{"value":"2321-3817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]}}}