Needle Phobia: A Vasovagal Response During Acupuncture.

COMMENTARY The phenomenon of fainting during acupuncture was first mentioned in the ancient Chinese medicine book Huangdi Neijing, which scholars date between the late Warring States period (475 to 221 BCE) and the Han dynasty (206 BCE to 220 CE). This reaction to acupuncture is familiar in Western contexts as needle phobia. Needle phobia can be a true phobia or a vasovagal response, which can be so severe that the patient begins to fear the debilitating effects of syncope almost more than the needles themselves. Recent systematic reviews have found the following interventions to be effective for needle phobia in children: distraction, hypnosis, and cognitive behavior therapy. In adults, interventions have not been as thoroughly studied, but the following are recommended: breathing techniques, applied muscle tension, and exposure. Hypnosis has been recommended in managing vasovagal responses to acupuncture, or using alternatives to needles, such as laser technology.