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Background and Aims Objective We report a case of persistent hiccups after rotator cuff repair surgery under inter scalene block and general anaesthesia.

Methods Case report A 42 years old fit and healthy male was admitted for a rotator cuff repair following contact sport injury. General anaesthesia was given with total intra venous anaesthesia with propofol and fentanyl with Laryngeal mask airway without paralysis. Ultrasound guided inter scalene brachial plexus block was given with single attempt injecting 10ml of 0.375% Ropivacaine. Duration of procedure was about 90 minutes and intra operative period was uneventful. He developed persistent hiccups in the afternoon with frequency in every 10-15 seconds which temporarily stopped while eating and drinking. Not responded to vagal manoeuvres, anti reflux treatment and metochlopramide. Symptoms were abruptly settled with a single dose of Promethazine.

Conclusion. Pathophysiology of hiccups is poorly understood and the aetiology can be variable. There are limited case reports of persistent hiccups following brachial plexus blocks.