Use of a nerve stimulator for phrenic nerve block in treatment of hiccups.

Abstract

HICCUPS may be managed with several methods, such as stimulation of the pharynx, compression of the eyeballs, gastric lavage, sedation, and inhalation of carbon dioxide. If these treatments fail, block of the phrenic nerve has been suggested as the last resort. Moore has suggested that if hiccups did not stop after the first attempt at blocking, the procedure should be repeated. Fluoroscopy or chest radiographs taken during inspiration and expiration (double-exposure method)4 can confirm the paralysis of the diaphragm after phrenic nerve block. However, even when the phrenic nerve is blocked, the diaphragm may not be paralyzed. Therefore, objective tests that would detect the successful phrenic nerve block are useful. We report the use of a nerve stimulator for confirmation of phrenic nerve block.