Calm patient receiving spinal anesthesia with gentle light symbolizing reduced anxiety.

Worried About Fainting During Spinal Anesthesia? How to Stay Calm and Safe

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Beau Callahan in Health & Wellness December 2025 • 4 min read.

"Discover how a simple premedication can significantly reduce your risk of vasovagal reactions and ensure a smoother experience with spinal anesthesia."


Vasovagal syncope, commonly known as fainting, occurs when blood pressure drops, reducing blood flow to the brain. Early symptoms include sweating, paleness, dizziness, blurred vision, and a feeling of faintness. If not promptly addressed, it can lead to a temporary loss of consciousness.

During spinal anesthesia, vasovagal reactions can be triggered by anxiety and stress. Spinal anesthesia involves injecting a local anesthetic into the lower back to numb the lower body. While generally safe, the procedure can cause anxiety in some individuals, increasing the risk of vasovagal syncope.

A recent study published in Acta Anaesthesiologica Scandinavica investigated the effectiveness of anxiolytic premedication in preventing vasovagal reactions during outpatient spinal anesthesia. The study aimed to determine if administering a mild sedative before the procedure could reduce anxiety and the incidence of fainting without delaying recovery or discharge.

The Calming Power of Premedication: How It Works

Calm patient receiving spinal anesthesia with gentle light symbolizing reduced anxiety.

The study, conducted at the University Medical Centre Mannheim, analyzed data from 2,747 patients who underwent outpatient perianal surgery with low-dose spinal anesthesia between January 2008 and June 2017. The researchers examined the incidence of vasovagal reactions, characterized by a drop in blood pressure and/or heart rate requiring cardiovascular support. Patients were categorized based on whether they received an anxiolytic premedication (1-2 mg of intravenous midazolam) before the procedure.

The results showed a significant reduction in vasovagal reactions among patients who received premedication: 7.5% compared to 15.0% in the non-premedicated group (P < 0.0001). This suggests that anxiolytic premedication can effectively reduce the risk of fainting during spinal anesthesia.

  • Reduced Anxiety: Anxiolytics help calm nerves, lowering the risk of anxiety-induced fainting.
  • Stable Blood Pressure: By reducing anxiety, these medications help maintain more stable blood pressure and heart rate.
  • Improved Experience: Patients feel more relaxed and comfortable during the procedure.
Importantly, the study also found that premedication did not prolong the time to achieve readiness for discharge. In fact, for patients receiving prilocaine, premedication led to a significantly earlier discharge (P = 0.0002). This challenges the common belief that sedatives always delay recovery.

What This Means for You

If you're scheduled for a procedure involving spinal anesthesia and are feeling anxious, talk to your doctor about the possibility of anxiolytic premedication. This simple intervention can significantly reduce your risk of vasovagal reactions, ensuring a more comfortable and safer experience. By addressing anxiety proactively, healthcare providers can improve patient outcomes and enhance the overall quality of care.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1111/aas.13297, Alternate LINK

Title: Influence Of Anxiolytic Premedication On Vasovagal Reactions And Home Readiness Following Outpatient Intrathecal Anaesthesia-A Retrospective Analysis

Subject: Anesthesiology and Pain Medicine

Journal: Acta Anaesthesiologica Scandinavica

Publisher: Wiley

Authors: Volker Gebhardt, Kevin Kiefer, Christel Weiss, Marc D. Schmittner

Published: 2018-12-03

Everything You Need To Know

1

What is vasovagal syncope, and how does it relate to spinal anesthesia?

Vasovagal syncope, commonly known as fainting, is a condition where blood pressure drops, reducing blood flow to the brain, which can lead to a temporary loss of consciousness. During spinal anesthesia, this can be triggered by anxiety and stress related to the procedure itself. Spinal anesthesia involves injecting a local anesthetic into the lower back, and while generally safe, the procedure can cause anxiety in some individuals, increasing the risk of vasovagal syncope.

2

What role does anxiolytic premedication play in preventing fainting during spinal anesthesia?

Anxiolytic premedication, such as intravenous midazolam, is used to reduce anxiety before spinal anesthesia. The study, conducted at the University Medical Centre Mannheim, demonstrated that patients who received anxiolytic premedication experienced a significant reduction in vasovagal reactions compared to those who did not. This is because anxiolytics help calm nerves and maintain more stable blood pressure and heart rate, which lowers the risk of fainting.

3

How effective is anxiolytic premedication in reducing vasovagal reactions during spinal anesthesia?

The study showed that anxiolytic premedication is highly effective. The results indicated a significant reduction in vasovagal reactions among patients who received premedication: 7.5% compared to 15.0% in the non-premedicated group (P < 0.0001). This suggests that administering a mild sedative before the procedure effectively reduces the risk of fainting during spinal anesthesia.

4

Are there any potential drawbacks to using anxiolytic premedication before spinal anesthesia, such as delayed recovery?

No, the study found that premedication did not prolong the time to achieve readiness for discharge. In fact, for patients receiving prilocaine, premedication led to a significantly earlier discharge (P = 0.0002). This challenges the common belief that sedatives always delay recovery, highlighting the benefits of premedication in enhancing the overall patient experience.

5

What should I do if I'm scheduled for a procedure involving spinal anesthesia and I'm feeling anxious?

If you're scheduled for a procedure involving spinal anesthesia and are feeling anxious, the best course of action is to talk to your doctor about the possibility of anxiolytic premedication. This simple intervention can significantly reduce your risk of vasovagal reactions, ensuring a more comfortable and safer experience. By addressing anxiety proactively, healthcare providers can improve patient outcomes and enhance the overall quality of care. Discussing your concerns with your healthcare provider will help you explore the best options for your specific situation.

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