Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Case Report Volume 7 Issue 7

Effectiveness of Transnasal Sphenopalatine Ganglion Block for Persistent Hiccups Treatment

Vakhtang Shoshiashvili*

Assistant Professor, Anesthesiologist, Department of Anesthesiology, Critical Care and Toxicology, TSMU First University Hospital, Tbilisi, Georgia

*Corresponding Author: AVakhtang Shoshiashvili, Assistant Professor, Anesthesiologist, Department of Anesthesiology, Critical Care and Toxicology, TSMU First University Hospital, Tbilisi, Georgia.

Received: June 12, 2023; Published: June 20, 2023

Abstract

Statement of the Problem: Hiccups are an involuntarily powerful spasm of the diaphragm, followed by a sudden inspiration with a closure of the glottis. Persistent and intractable hiccups can cause dehydration, insomnia, depression, gastroenteric disorders, such as gastroesophageal reflux, and even death. Treatment options are multiple including conservative treatment, nerve blocks such as the phrenic nerve and sympathetic/parasympathetic ganglion blocks and surgical treatment.

Case Presentation: Case 1. 50 years old man had persistent hiccups during 10 days with insomnia, depression, gastrointestinal disorders. Patient was drug abused, former military person. He had chronic hepatitis C. He was treated with chlorpromazine without any result. After two sided transnasal sphenopalatine ganglion block with 2% lidocaine application during 5 minutes hiccup improved without relapse. No additional treatment was needed. Case 2. 67 years old men with hiccups, insomnia and depression during 7 days. No specific treatment before hospital admission. Concomitant disease – controlled arterial hypertension, ischemic stroke 3 years ago without neurological consequences. As a result of two sided transnasal sphenopalatine ganglion block with 2% lidocaine application during 5 minutes hiccup improved, but after two hours hiccup relapsed with less intensiveness and sphenopalatine ganglion block repeated. Hiccup improved without relapse. No additional treatment was needed.

Conclusion: Sphenopalatine ganglion block is an effective tool for the treatment of persistent hiccup. Due to its simplicity, safety and effectiveness it can serve as a first treatment option of hiccups. In case of hiccup relapse, it can be repeated.

 Keywords: Hiccups; Sphenopalatine Ganglion Block; Diaphragm; Phrenic Nerve; Parasympathetic Ganglion

References

  1. Steger M., et al. “Systemic review: the pathogenesis and pharmacological treatment of hiccups”. Alimentary Pharmacology and Therapeutics 42 (2015): 1037-1050.
  2. , et al. “Sphenopalatine ganglion neuromodulation in migraine: What is the rationale? Review Article”. November 2013 Cephalalgia 34.5 (2013).
  3. Chang FY and Lu CL. “Hiccup: mystery, nature and treatment”. Journal of Neurogastroenterology and Motility 18 (2012): 123-130.
  4. Cole JA and Plewa MC. “Singultus”. In: StatPearls. Treasure Island (FL): StatPearls Publishing; (2023).
  5. Lopez DJ and Kumar S. “Stellate Ganglion Block for Intractable Hiccups Secondary to a Motor Vehicle Collision”. Cureus4 (2023): e37030.
  6. Lee AR., et al. “Treatment of persistent postoperative hiccups with stellate ganglion block: Three case reports”. Medicine (Baltimore)48 (2018): e13370.
  7. Hee-won Son., et al. “Stellate ganglion block for the treatment of intractable hiccups: A case report”. Anesthesia and Pain Medicine2 (2018): 192-196.
  8. Lipov EG., et al. “A unifying theory linking the prolonged efficacy of the stellate ganglion block for the treatment of chronic regional pain syndrome (CRPS), hot flashes, and posttraumatic stress disorder (PTSD)”. Medical Hypotheses 72 (2009): 657-661.
  9. Alexander CE and Dua A. “Sphenopalatine Ganglion Block”. In: StatPearls. Treasure Island (FL): StatPearls Publishing (2023).
  10. Piagkou M., et al. “The pterygopalatine ganglion and its role in various pain syndromes: from anatomy to clinical practice”. Pain Practice5 (2012): 399-412.
  11. Windsor RE and Jahnke S. “Sphenopalatine ganglion blockade: a review and proposed modification of the transnasal technique”. Pain Physician2 (2004): 283-286.
  12. Vakhtang Shoshiashvili. “Transnasal sphenopalatine ganglion block for postdural puncture headache treatment after spinal anesthesia – case report”. Anesthesia (2020).
  13. Vakhtang Shoshiashvili. “Transnasal Sphenopalatine Ganglion Block for Postdural Puncture Headache Treatment after SpinalAnesthesia – Case Report”. Anesthesia and Pain Research1 (2019): 1-4.
  14. Chua H., et al. “Transnasal sphenopalatine ganglion block for post-dural puncture headache and associated tinnitus”. Anaesthesia Report1 (2021): 37-40.
  15. Waldman SD. “Atlas of interventional pain management”. 4th Philadelphia: Elsevier (2015).
  16. Candido KD., et al. “A novel revision to the classical transnasal topical sphenopalatine ganglion blockfor the treatment of headache and facial pain”. Pain Physician 16 (2013): E769-778.

Citation

Citation: Vakhtang Shoshiashvili. “Effectiveness of Transnasal Sphenopalatine Ganglion Block for Persistent Hiccups Treatment”.Acta Scientific Medical Sciences 7.7 (2023): 107-111.

Copyright

Copyright: © 2023 Vakhtang Shoshiashvili. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor1.403

Indexed In





News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is May 30, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US