Management of laryngeal mask airway induced hiccups using dexmedetomedine

Koteswara, Chethan Manohara; Dubey, Jitendra Kumar

doi:10.4103/0019-5049.108583

Cited by 4 publications

(6 citation statements)

References 5 publications

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“…They proposed the use of dexmedetomidine instead of atropine or ephedrine which have been reported to abolish perioperative hiccups but may cause unacceptable increases in heart rate and blood pressure. [25] However, dexmedetomidine is not readily available in many centers including ours.…”

Section: Discussionmentioning

confidence: 99%

Comparison the Effects of Ephedrine and Lidocaine in Treatment of Intraoperative Hiccups in Gynecologic Surgery under Sedation

2018

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Background:This study aimed to evaluate and compare the therapeutic effects of ephedrine and lidocaine in treatment of intraoperative hiccups in gynecologic surgery under sedation.Materials and Methods:This randomized clinical trial in Isfahan was done on fifty female patients referring to Shahid Beheshti Hospital who needed to have sedation for medical interventions and they afflicted hiccups during surgery or sedation. Patients divided into two groups of 25 randomly assigned to one of the two groups of ephedrine or lidocaine. Ephedrine group received 5 mg/kg of medicine, while the lidocaine group was under treatment with 1 mg/kg lidocaine. Patients were monitored about systolic and diastolic blood pressure, MAP, heart rate, duration of hiccup, frequency of betterment, duration of intervention, and recovery at 15-min intervals of surgery and recovery.Results:Hiccups were resolved in 14 cases (56%) in the lidocaine group, while the improvement of such problem was achieved in 24 cases (96%) in ephedrine group (P < 0.001), so that the two groups did not have any significant difference in terms of the time of onset but the stop time of hiccups (relative to its start time) in the ephedrine group with the mean value of (2.40 ± 1.16) was significantly lower than the lidocaine group with the mean of 19.64 ± 22.76 min (P = 0.014). In addition, no complications were observed in the two groups.Conclusion:Ephedrine has been more successful than lidocaine as a stimulant in controlling hiccups, and it has been able to suppress hiccups in a higher percentage of patients at a shorter time.

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Section: Discussionmentioning

confidence: 99%

Comparison the Effects of Ephedrine and Lidocaine in Treatment of Intraoperative Hiccups in Gynecologic Surgery under Sedation

2018

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“…This suggested a significantly greater incidence of gastroesophageal reflux in the awake group. And gastro-oesophageal reflux is an aetiological factor for hiccups [11]. They concluded that it may be safer to remove the LMA whilst the patients are deeply anaesthetized in the operating room than when they are awake often in the recovery room.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, Koteswara et al in a case report noted that dexmedetomidine-a selective alpha-2 adrenergic receptor agonist abolished hiccup in a similar condition, implying that sympatholysis may have a role in suppressing intraoperative hiccup [11]. They proposed the use of dexmedetomidine instead of atropine or ephedrine which have been reported to abolish perioperative hiccups, but may cause unacceptable increases in heart rate and blood pressure [11].…”

Section: Discussionmentioning

confidence: 99%

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Postoperative Hiccup Induced by LMA—A Case Report with Literature Review

Nwagwu¹,

Ebirim²

2014

OJAnes

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Background: The laryngeal mask airway (LMA) has become popular due to simplicity of its use and its important function in difficult airway management. However, some complications have been associated with its use. A case report and review of literature on hiccups associated with the use of LMA is presented. Case Report: A 24-year-old man who presented with a right inguinoscrotal hernia was scheduled for elective surgery under general anaesthesia. He denied any co-existing medical illness. Physical examination showed a normal healthy patient and he was placed in class 1 of the American Society of Anesthesiologist (ASA) physical status category. After premedication with 0.6 mg atropine, general anaesthesia was induced with 200 mg of intravenous propofol. Size 5 classic LMA was inserted, and surgery had lasted for 45 minutes. He had hiccups immediately after removal of the LMA which lasted for 6 minutes, and stopped about 95 seconds after 0.6 mg intravenous atropine was given. Conclusion: Complications from the use of LMA may be rare but still possible. It is important to adhere to the guidelines for insertion and removal of the LMA and perioperative use of the device should strictly be by trained personnel.

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“…1 The afferent pathways of the hiccup reflex arc have vagal, phrenic, and sympathetic (T6-T12) branches as their components and efferent pathways have motor fibers of the phrenic nerve to diaphragm, nerve to the glottis, and accessory nerves to intercostal muscles as their components. 2 Acute hiccups are usually benign and self-limiting requiring no treatment. Persistent and intractable hiccups have several medical, surgical, and drug-induced causes.…”

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confidence: 99%