Abstract
Phrenic Nerve Block used to Treat Persistent Hiccups Provoked by a Nissen’s Fundoplication
Highlights
Hiccups are produced by contraction of the diaphragm and the accessory inspiratory muscles resulting in abrupt closure of the glottis accompanied by a characteristic sound [1,2,3,4,5,6]
The same procedure was repeated one week later - a perfusion of levobupivacaine was administered for 24 h by means of a perineural catheter placed with the aid of ultrasound and electrical stimulation
An elevation of the left hemi diaphragm was observed in the chest X-ray due to the left phrenic nerve paralysis but there were no apparent respiratory repercussions (Figure 2)
Summary
Hiccups are produced by contraction of the diaphragm and the accessory inspiratory muscles resulting in abrupt closure of the glottis accompanied by a characteristic sound [1,2,3,4,5,6]. Etiology of hiccups includes pathology in the central nervous system, abdomen, or thorax and general anesthesia [1]. Six months after surgery she developed persistent hiccups of such an intensity and frequency that it affected her quality of life; treatment with PPIs and prokinetics was begun and diagnostic tests were conducted - the barium transit test, manometry and pH-metry – results were all normal.
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