Abstract
Intractable hiccups is defined as hiccups lasting more than 48 hours. Emergency treatment of intractable hiccups is divided into pharmacological and nonpharmacological management. It has been reported that nerve block therapy may be useful for stopping hiccups that are unresponsive to both physical maneuvers and drug therapy.
We treated seven patients who had intractable hiccups with cervical or thoracic epidural block, or stellate ganglion block (SGB). Of those seven patients, three patients had hiccups after upper abdominal surgery; two patients had hiccups that originated in the central nervous system and abdominal organ, respectively; and two patients had idiopathic hiccups. We were able to stop the intractable hiccups in six of seven (86 per cent) patients using epidural block or SGB, without any complication. The duration of treatment ranged from 1 to 60 days (average, 15 days). Epidural block or SGB inhibits the pathway of the hiccup reflex arc, including the phrenic nerve and the thoracic sympathetic chain. Our results indicate that an epidural block or SGB is a useful method for treating intractable hiccups.
