RT Journal Article
SR Electronic
T1 Ultrasound-Guided Continuous Phrenic Nerve Block for Persistent Hiccups
JF Regional Anesthesia & Pain Medicine
JO Reg Anesth Pain Med
FD BMJ Publishing Group Ltd
SP 455-457
OP 455-457
DO 10.1097/AAP.0b013e3181e8536f
VO 35
IS 5
A1 Steven H. Renes
A1 Geert J. van Geffen
A1 Harald C. Rettig
A1 Mathieu J. Gielen
A1 Gert J. Scheffer
YR 2010
UL http://rapm.bmj.com/content/35/5/455-457.abstract
AB Background: Phrenic nerve block can be performed and repeated if necessary for persistent hiccups, when conservative and pharmacological treatment is unsuccessful. We report the first description of an in-plane ultrasound (US)-guided phrenic nerve block (PhNB) with a catheter, after US investigation of the bilateral diaphragm, to treat hiccups while avoiding repeated PhNBs.Case: A 36-year-old man had persistent postoperative hiccups not responding to conservative and pharmacological treatment. Bilateral diaphragmatic US evaluation showed abnormal right-sided movement. A right-sided in-plane US-guided PhNB with catheter was performed. Injection of local anesthetic stopped the hiccups, and a continuous infusion of local anesthetic was started for 24 hrs. After discontinuation of the infusion, the hiccups recurred. Restart of the continuous infusion of the local anesthetic through the catheter was performed, and after discontinuation 24 hrs later, no further hiccups occurred. No adverse effect occurred.Conclusions: An US-guided in-plane PhNB with catheter is feasible and avoids repeated PhNB when hiccups reoccur. Ultrasound investigation of the bilateral diaphragm should be performed before performing the nerve block.