Persistent Hiccups Following Stapedectomy

Objective: We report a case of a 37 year-old man who developed persistent hiccups after elective stapedectomy. Method and Results: The diagnostic approach is discussed as well as the non-pharmacologic and pharmacologic treatments and overall management. The aim is to stress that there is a variety of potential factors that can induce hiccups perioperatively and in cases like this a step by step approach must be taken. Conclusion: Persistent hiccups are very rare following stapedectomy, control of them is crucial for the successful outcome. The trigger may be more than one factors and the good response to treatment may be due to dealing successfully with more than one thing

Treatment of Intractable Hiccups With an Oral Agent Monotherapy of Baclofen -A Case Report-

Hiccups are an involuntarily powerful spasm of the diaphragm, followed by a sudden inspiration with a closure of the glottis. Hiccups that are caused by gastric distention, spicy foods and neural dysfunction can resolve themselves without any treatment. Some hiccups are associated with certain diseases or they occur postsurgically, and life-restricting intractable hiccups should be treated. The cause of hiccups should be quickly determined so as to administer the proper treatment. Hiccups often remit spontaneously within a short period of time, but they may also occur without remission for a prolonged period in some cases. We report here on a 36-year-old man who suffered with intractable hiccups for 5 years. We administered a single oral dose of baclofen, and then the hiccups disappeared. We conclude that a single dose of baclofen is a good treatment for intractable hiccups

Intractable hiccups caused by pulmonary embolism. A case report

The list of signs and symptoms of pulmonary embolism is very long. However, none of the authors has previously reported that pulmonary embolism may be the cause of intractable hiccups. We present here the case of a 58-year-old man with lung cancer, who consulted us because of intractable, continuous hiccups which had been uninterrupted for four weeks. None of the known pharmacological therapies was successful. Thrombosis of the vena cava inferior was found on the abdominal ultrasound, and despite the lack of any evidence it was thought that thrombosis and probable pulmonary emboli may be related to the hiccups. The patient was treated with Deltaparin sodium and the hiccups stopped after 48 hours. As the patient deteriorated a couple of weeks later, the hiccups reappeared when Deltaparin was discontinued. He passed away peacefully. Adv. Pall. Med. 2010; 9, 4: 149–152The list of signs and symptoms of pulmonary embolism is very long. However, none of the authors has previously reported that pulmonary embolism may be the cause of intractable hiccups. We present here the case of a 58-year-old man with lung cancer, who consulted us because of intractable, continuous hiccups which had been uninterrupted for four weeks. None of the known pharmacological therapies was successful. Thrombosis of the vena cava inferior was found on the abdominal ultrasound, and despite the lack of any evidence it was thought that thrombosis and probable pulmonary emboli may be related to the hiccups. The patient was treated with Deltaparin sodium and the hiccups stopped after 48 hours. As the patient deteriorated a couple of weeks later, the hiccups reappeared when Deltaparin was discontinued. He passed away peacefully. Adv. Pall. Med. 2010; 9, 4: 149–15

Intractable Hiccups and a Posterior Fossa Arteriovenous Malformation: A Case Report

A 29-year-old man is presented who developed intractable hiccups following a subarachnoid hemorrhage from a posterior fossa dural arteriovenous malformation (AVM). The hiccups persisted even after various treatments had been attempted, and the AVM had been excised surgically. The hiccups stopped after a bilateral phrenic nerve section was performed. This report reviews the central causes and mechanisms of hiccups and emphasizes the importance of selective vertebral angiography in demonstrating posterior fossa AVM

Hiccups in the Neuro-Critical Care Unit: A Symptom Less Studied?

Background: Hiccups (also referred to as “hiccoughs”) are usually a transient condition that affects almost everyone in their lifetime. However, persistent and intractable hiccups are the types which are often linked with unfavorable outcomes and can also result in respiratory alkalosis in the intubated patients. There is no accurate estimate of the prevalance of hiccups in the patients admitted in the neuro-ICU.The most commonly witnessed hiccups in the neuro-ICU are intractable and neurogenic in nature. In this communication, we discuss the strategy of respiratory care and pharmacological management of hiccups in an adult male post decompressive craniotomy in view of unilateral basal ganglion bleed.  He suffered from persistent hiccups and was managed conservatively with intravenous Metachlorpromide 10 mg on as and when needed (SOS) basis. In conclusion, it seems that persistent and intractable hiccups as a risk factor for ventilator-associated pneumonia in patients who are intubated and mechanically ventilated should be given due attention. We encourage clinical trials in this area of critical care medicine and should also encourage more studies to analyse the effectiveness of non-pharmacological methods

Treatment of Idiopathic Persistent Hiccups with Positive Pressure Ventilation -A Case Report-

A 41-year-old male patient presented with idiopathic persistent hiccups. The hiccups did not respond to pharmacologic treatments including cisapride, omeprazole, and baclofen. Phrenic nerve block was also ineffective. However, the persistent hiccups were successfully treated with short-term positive pressure ventilation using a short-acting muscle relaxant

Hiccups for HIPCs?

In this paper we discuss fiscal and monetary policy issues facing heavily-indebted poor countries (HIPCs) who receive debt reduction via the enhanced HIPC initiative. This debt relief program is distinguished from previous ones by its conditionality: freed resources must be used for poverty reduction. We argue that (i) this conditionality severely limits the extent to which the initiative provides significant debt relief; (ii) depending on the response of monetary policy to an increase in social spending there could be a short-run increase in inflation in HIPC countries and (iii) the keys to long-run fiscal sustainability in the HIPCs are significant fiscal reforms by their governments, and the effectiveness of their poverty reduction programs in raising growth.

Persistent Hiccups After Cervical Epidural Steroid Injection.

BACKGROUND Hiccup is a rare complication after a cervical epidural steroid injection used in the treatment of chronic pain. A few studies have reported on the physiological and pharmacological aspects of hiccups after epidural steroid injection and there have been some case reports published. Our presented case report provides insight into the side effect of hiccups that can occur in association with cervical epidural analgesia, and will help inform anesthesiologist about this unpleasant complication. CASE REPORT We present a rare case of persistent hiccups after a cervical epidural steroid injection in a 60-year-old male patient with chronic pain due to disc protrusion in C3-C7. CONCLUSIONS Persistent hiccups after epidural injection is a serious complication. As the exact mechanism of hiccups is not yet known, regardless the level of epidural or the mixture of drugs used, and the incident of hiccups after epidural injection is not well-reported, we think that the etiology and the incident rate must be further evaluated

Hiccups in the Neuro-Critical Care Unit: A Symptom Less Studied?

Background: Hiccups (also referred to as “hiccoughs”) are usually a transient condition that affects almost everyone in their lifetime. However, persistent and intractable hiccups are the types which are often linked with unfavorable outcomes and can also result in respiratory alkalosis in the intubated patients. There is no accurate estimate of the prevalance of hiccups in the patients admitted in the neuro-ICU.The most commonly witnessed hiccups in the neuro-ICU are intractable and neurogenic in nature. In this communication, we discuss the strategy of respiratory care and pharmacological management of hiccups in an adult male post decompressive craniotomy in view of unilateral basal ganglion bleed.  He suffered from persistent hiccups and was managed conservatively with intravenous Metachlorpromide 10 mg on as and when needed (SOS) basis. In conclusion, it seems that persistent and intractable hiccups as a risk factor for ventilator-associated pneumonia in patients who are intubated and mechanically ventilated should be given due attention. We encourage clinical trials in this area of critical care medicine and should also encourage more studies to analyse the effectiveness of non-pharmacological methods

Hiccups for HIPCs?

Debt relief, HIPCs, Conditionality, Government budget constraint