Gabapentin in the treatment of persistent hiccups in advanced malignancy

Menon, Mahesh

doi:10.4103/0973-1075.100839

Cited by 11 publications

(25 citation statements)

References 16 publications

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“…Several studies involving treatment of neuropathic cancer pain found gabapentin to be the most commonly prescribed adjuvant [24, [66][67][68][69][70][71]. Gabapentin is also effective in a multitude of other symptoms including insomnia [72][73][74], cough [75][76][77], hiccough [78][79][80], nausea [81][82][83], and delirium [84]. The use of steroids may be for multiple reasons, i.e., as an adjuvant but also for non-pain symptoms such as fatigue and anorexia [85,86].…”

Section: Discussionmentioning

confidence: 99%

Use of non-opioid analgesics as adjuvants to opioid analgesia for cancer pain management in an inpatient palliative unit: does this improve pain control and reduce opioid requirements?

Shinde

Gordon

Sharma

et al. 2014

Support Care Cancer

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Background Cancer pain is complex, and despite the introduction of the WHO cancer pain ladder, few studies have looked at the prevalence of adjuvant medication use in an inpatient palliative medicine unit. In this study, we evaluate the use of adjuvant pain medications in patients admitted to an inpatient palliative care unit and whether their use affects pain scores or opiate dosing. Methods In this retrospective observational study, patients admitted to the inpatient palliative care unit over a 3-month period with a diagnosis of cancer on opioid therapy were selected. Data pertaining to demographics, diagnosis, oral morphine dose equivalent of the opioid at the time of discharge, adjuvant analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs), and pain scores as reported by nurses and physicians were collected. Results Seventy-seven patients were eligible over a 3-month period, out of which 65 (84 %) were taking an adjuvant medication. The most commonly prescribed adjuvant was gabapentin (70 %). Fifty-seven percent were taking more than one adjuvant. There were more women in the group receiving adjuvants (57 vs. 17%, p=0.010). Those without adjuvants compared with those on adjuvants did not have worse pain scores on discharge as reported by physicians (0.8±0.8 vs. 1.0±0.7, p=0.58) or nurses (2.0±2.7 vs. 2.1±2.6, p=0.86). There was no difference in morphine equivalent doses of the opioid in both groups (median (min, max); 112 (58, 504) vs. 200 (30, 5,040)) at the time of discharge; 75-80 % of patients had improvement in pain scores as measured by a two-point reduction in numerical rating scale (NRS). Discussion This study shows that adjuvant medications are commonly used for treating pain in patients with cancer. More than half of study population were on two adjuvants or an adjuvant plus NSAID along with an opioid. We did not demonstrate any benefit in terms of improved pain scores or opioid doses with adjuvants, but this could reflect confounding variables and physician choice. Larger prospective studies are needed to define the opioid-sparing effects of adjuvants. Conclusion Adjuvant agents are used in over 80 % of those treated for cancer pain.

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Section: Discussionmentioning

confidence: 99%

Use of non-opioid analgesics as adjuvants to opioid analgesia for cancer pain management in an inpatient palliative unit: does this improve pain control and reduce opioid requirements?

Shinde

Gordon

Sharma

et al. 2014

Support Care Cancer

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“…Respiratory maneuvers such as breath holding and rebreathing induced hypercapnia along with the valsalva maneuver can also be used to treat hiccups. Pharmacological treatment comprises metoclopramide and most recently drugs such as gabapentin are being used to treat hiccups [7].…”

Section: Discussionmentioning

confidence: 99%

Intractable Hiccups in a Young Male: Is it a Tell-Tale Sign of Pseudocyst of Pancreas?

Talwar¹,

Kumar²,

Acharya³

et al. 2021

Cureus

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Although encountered routinely in the outpatient department, hiccups or singultus are mostly neglected by the clinicians owing to its benign presentation and self-limiting nature. However, an innocent-looking symptom such as a hiccup can be a warning sign of serious underlying medical conditions and hence should be addressed seriously. Hiccups can seriously alter the quality of life and induce anxiety when they become intractable. We present an atypical case of a 30-year-old male who presented with intractable hiccups for four months and upon investigations revealed to be a case of chronic pancreatitis with pseudocyst of the pancreas. The patient's intractable hiccups were not responding to metoclopramide and responded well to gabapentin. The patient was managed conservatively for chronic pancreatitis and pseudocyst of the pancreas. This case report highlights the importance of investigating the cause of a simple symptom like hiccup as it can be a tell-tale sign of a chronic underlying pathology such as pseudocyst of the pancreas in our case. After an extensive review of literature, it was found that this is the first case to report intractable singultus as a result of the pseudocyst of the pancreas.

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“…Recurrent hiccups occur in about 3% of the healthy population, compared to approximately 20% with Parkinson disease and 10% of patients with gastroesophageal reflux disease (GERD) [11]. Overall, the prevalence of hiccups in advanced cancer has been reported to be 3.9%-4.8% [12,13]. A variety of CNS pathologies cause IH.…”

Section: Epidemiologymentioning

confidence: 99%

Hiccups in neurocritical care

et al. 2021

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Hiccup or hiccough is known by the medical term "singultus," which is a derivative of the Latin word "singult, " meaning "a gasp" or "a sob" [1]. Hiccups are characterized by involuntary, intermittent, repetitive, myoclonic, and spasmodic contractions of the diaphragm and the inspiratory intercostal muscles, leading to an abrupt and early closure of the glottis, terminating inspiration and generating the characteristic "hic" sound [2,3]. Both healthy adults and children commonly experience hiccup spells. In the fetus, hiccups play a physiological role by training the respiratory muscles for their breathing function, and as a reflex preventing amniotic fluid aspiration [4,5]. Transient episodes usually do not

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Gabapentin in the treatment of persistent hiccups in advanced malignancy

Cited by 11 publications

References 16 publications

Use of non-opioid analgesics as adjuvants to opioid analgesia for cancer pain management in an inpatient palliative unit: does this improve pain control and reduce opioid requirements?

Use of non-opioid analgesics as adjuvants to opioid analgesia for cancer pain management in an inpatient palliative unit: does this improve pain control and reduce opioid requirements?

Intractable Hiccups in a Young Male: Is it a Tell-Tale Sign of Pseudocyst of Pancreas?

Hiccups in neurocritical care

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