Persistent Hiccups After Attempted Interscalene Brachial Plexus Block

Homer, J.; Davies, Joanna M.; Amundsen, Laurie B.

doi:10.1016/j.rapm.2005.07.187

Cited by 12 publications

(11 citation statements)

References 9 publications

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“…Non-pharmacological therapy is method to inhibit afferent pathway of vagus nerve, for example, holding a breath, drinking cold water, and inserting a nasogastric tube. If non-pharmacological therapy is ineffective, drugs such as metoclopramide, chlorpromazine, amitriptyline, phenytoin, valproic acid can be used [1]. Recently, baclofen and gabapentin have been selected for monotherapy or combination therapy.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound-guided Pulsed Radiofrequency Lesioning of the Phrenic Nerve in a Patient with Intractable Hiccup

et al. 2010

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Persistent and intractable hiccups (with respective durations of more than 48 hours and 1 month) can result in depression, fatigue, impaired sleep, dehydration, weight loss, malnutrition, and aspiration syndromes. The conventional treatments for hiccups are either non-pharmacological, pharmacological or a nerve block treatment. Pulsed radiofrequency lesioning (PRFL) has been proposed for the modulation of the excited nervous system pathway of pain as a safe and nondestructive treatment method. As placement of the electrode in close proximity to the targeted nerve is very important for the success of PRFL, ultrasound appears to be well suited for this technique. A 74-year-old man suffering from intractable hiccups that had developed after a coronary artery bypass graft and had continued for 7 years was referred to our pain clinic. He had not been treated with conventional methods or medications. We performed PRFL of the phrenic nerve guided by ultrasound and the hiccups disappeared.

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Section: Discussionmentioning

confidence: 99%

“…However, if they last longer than usual, this illness can cause dehydration, impaired sleep, depression, gastroenteric disorders, and even death [1]. Usually, hiccups stop within 48 hours.…”

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confidence: 99%

Ultrasound-guided Pulsed Radiofrequency Lesioning of the Phrenic Nerve in a Patient with Intractable Hiccup

et al. 2010

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“…In serial sections, fatty tissue was observed. Microscopically, the tumor was a mesenchymal lesion composed of smooth muscle cells, mature Metabolic derangements and drugs are also frequently implicated as causes for hiccups (14). In our patient, the hiccups were unrelated to the retroperitoneal mass and, therefore, did not resolve after the operation.…”

Section: Discussionmentioning

confidence: 60%

“…In the literature, persistent hiccups are defined as those lasting longer than 48 hours, whereas intractable hiccups are those lasting longer than one month (14). Persistent or intractable hiccups may lead to fatigue, sleep disturbances, and dehydration.…”

Section: Discussionmentioning

confidence: 99%

Extraperitoneal pelvic myolipoma: radiological findings

Ulu

Kırbaş²,

Töre³

et al. 2008

Diagn Interv Radiol

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Myolipoma is a very rare adipocytic tumor occurring most frequently in adults, and usually is located in the retroperitoneum or abdomen. It has been described in the retroperitoneum, spinal cord, orbita, breast, round ligament, subcutaneous tissue, pericardium, rectus sheath of the abdominal wall, and abdominal cavity with attachment to the abdominal wall. Most of these tumors are discovered incidentally and are large when discovered. Radiological findings are nonspecific due to the nonlipomatous component of the tumor. We present radiological findings of a large extraperitoneal pelvic myolipoma adjacent to the anterior abdominal wall, detected incidentally in an elderly woman with a presenting complaint of intractable hiccups.

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“…Several therapies aiming at disrupting the transmission of impulses along the phrenic nerves have been suggested, a nerve block being one of the methods. On the other hand, persistent hiccups after attempted interscalene brachial plexus block have also been reported [2]. During the past few years, ultrasound (US) has been found useful for anesthetizing and assessing disorders affecting peripheral nerves.…”

Section: Introductionmentioning

confidence: 99%

Phrenic nerve block with ultrasound-guidance for treatment of hiccups: a case report

Kuusniemi

Pyylampi

2011

J Med Case Reports

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IntroductionPersistent hiccups can be more than a simple and short-lived nuisance and therefore sometimes call for serious consideration. Hiccupping episodes that last only a few minutes may be annoying, but persistent hiccups may initiate many major complications.Case presentationA 72-year-old Caucasian man with spinal stenosis presented for L4-5 laminectomy under spinal anesthesia. The surgery and anesthesia, as well as the perioperative period, passed without any incident, except for persistent postoperative hiccups not responding to conservative and pharmacological treatment. Hiccups resulted in a prolonged hospital stay as they lasted until the seventh postoperative day. On that day, a right-sided ultrasound-guided phrenic nerve block with 5 ml of bupivacaine 5 mg/ml with epinephrine was performed successfully with a single-injection technique. Ten minutes after the procedure the hiccups vanished and a partial sensomotoric block of his right shoulder developed. No adverse effect occurred; our patient could be discharged on the same day and the hiccups did not return.ConclusionUltrasound provides us with non-invasive information regarding anatomy and allows anesthesiologists to visualize needle insertion, to identify the exact location of the injected solution and to avoid such structures as arteries or veins. As such, this method should be actively utilized. In cases where both pharmacological and non-pharmacological treatments prove to be ineffective when treating persistent hiccups, a single-shot ultrasound-guided technique should be considered before the patient becomes exhausted.

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Persistent Hiccups After Attempted Interscalene Brachial Plexus Block

Abstract: Persistent hiccups have many postulated causes, including several that are common in the perioperative period, but this is the first time to our knowledge that persistent hiccups have been described in association with attempted interscalene brachial plexus block.

Cited by 12 publications

References 9 publications

Ultrasound-guided Pulsed Radiofrequency Lesioning of the Phrenic Nerve in a Patient with Intractable Hiccup

Ultrasound-guided Pulsed Radiofrequency Lesioning of the Phrenic Nerve in a Patient with Intractable Hiccup

Extraperitoneal pelvic myolipoma: radiological findings

Phrenic nerve block with ultrasound-guidance for treatment of hiccups: a case report

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