Advertisement

Intradermal injection for hiccup therapy in the Emergency Department

Published:March 25, 2020DOI:https://doi.org/10.1016/j.ajem.2020.03.044

      Abstract

      Hiccup is a condition caused by involuntary contraction of inspiratory muscles, especially the diaphragm. Although it is generally considered as a physiological.
      response, if hiccup persists for a long time, it can lead to many undesirable conditions such as depression, weight loss, insomnia, and fatigue. A 35-year-old male patient was admitted to our emergency department with hiccup lasting for 15 h. He had a history of several hiccup attacks. Classical non-pharmacological and pharmacological therapies were used to treat the condition without any response. As an alternative method, an intradermal injection was applied. A mixture of thiocolchicoside and lidocaine was administered intradermally to a depth of 1–3 mm at the epigastric region and adjacent to the sternocleidomastoid muscle. The patient's hiccup ended after the intradermal injection procedure. During 48 h of follow-up the hiccup attack did not develop again. No complications related to the process were detected. This is the first case in the literature demonstrating the use of intradermal injection to terminate hiccups. The intradermal injection approach can be administered in cases of hiccups that do not respond to medical treatment.
      To read this article in full you will need to make a payment
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The American Journal of Emergency Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Petroianu G.A.
        Treatment of hiccup by vagal maneuvers.
        J Hist Neurosci. 2015; 24: 123-136
        • Cymet T.C.
        Retrospective analysis of hiccups in patients at a community hospital from 1995–2000.
        J Natl Med Assoc. 2002; 94: 480-483
        • Steger M.
        • Schneemann M.
        • Fox M.
        Systemic review: the pathogenesis and pharmacological treatment of hiccups.
        Aliment Pharmacol Ther. 2015; 42: 1037-1050
        • Gallagher J.
        Anterior and posterior diaphragm kinesio taping for intractable hiccups after ischemic stroke: a case report.
        Medicine (Baltimore). 2018; 97e11934
        • Rouse S.
        • Wodziak M.
        Intractable hiccups.
        Curr Neurol Neurosci Rep. 2018; 18: 51
        • Coz J.L.
        Traite de mesotherapie (Ağrı ve Estetikte Mezoterapinin Yeri Le Coz). Ayşegül Girgin, Aslı Şimsek Azlar translator. : Kongre Kitapevi.
        2020
        • Eisenacher A.
        • Spiske J.
        Persistent hiccups (singultus) as the presenting symptom of medullary cavernoma.
        Dtsch Arztebl Int. 2011; 108: 822-826
        • Kim J.E.
        • Lee M.K.
        • Lee D.K.
        • Choi S.S.
        • Park J.S.
        Continuous cervical epidural block: treatment for intractable hiccups.
        Medicine (Baltimore). 2018; 97e9444
        • Pittman T.
        • DiStephano A.
        • Chow R.
        • Samet R.
        Ultrasound-guided phrenic nerve block for intractable hiccups in patients with metastatic colon cancer: a case report.
        J Palliat Care Med. 2017; 7: 2