Intraoperative Laryngeal Mask Airway-Related Hiccup: An Overview

Abstract

Hiccup is an involuntary contraction of the diaphragm and intercostal muscles resulting in sudden inspiration and closure of the glottis. The presence of hiccup in the perioperative period can be a challenging problem. Sudden movements of the patient from hiccups can interfere preoperative diagnostic procedures, intraoperative hiccup may delay the beginning of surgery, interfere with the surgical process, and affect intraoperative monitoring, and postoperative hiccup may affect would healing and hemodynamic stability. Hiccup can lead to have increased aspiration risk. Hiccup are is an incompletely understood phenomenon with multiple etiologies. Intraoperative hiccup related to laryngeal mask airway placement has been reported, and it presents unique challenges in diagnosis and management. Both pharmacological and non-pharmacological interventions have been utilized with various level of success. All treatment strategies are primarily aimed at interrupting the hiccup reflex arc.

Comparison of remimazolam tosylate and propofol in patients undergoing general anesthesia using a laryngeal mask airway without muscle relaxants

“…Hiccups can be triggered by stimulation of the vagus nerve or phrenic nerve, with the vagus nerve innervating the pharynx and upper esophagus. Previous studies have indicated that LMA insertion can stimulate the hypopharynx and induce hiccups, with reported incidences ranging from 3% to 11% [12,13]. However, in our study, only one patient experienced hiccups after LMA insertion, while five patients experienced hiccups during or after the bolus administration of remimazolam.…”

Intractable hiccups under general anesthesia in a pediatric patient

“…An inadvertent gastric insufflation during poor bag-mask ventilation technique or other patient-related factors, and prior diagnosis of gastroesophageal reflux disease may also present with intraoperative hiccups and are reported in about 4.5–9.5% of the patients. [ 5 ] LMA insertion has been claimed to inhibit hiccups[ 6 ] as well as implicated as a cause for this,[ 5 7 ] with an overall incidence of 5% that differed with the type of induction agent used intraoperatively. [ 5 ]…”

“…[ 5 ] LMA insertion has been claimed to inhibit hiccups[ 6 ] as well as implicated as a cause for this,[ 5 7 ] with an overall incidence of 5% that differed with the type of induction agent used intraoperatively. [ 5 ]…”

“…There are several pharmacological and non-pharmacological management strategies mentioned in the literature for the intraoperative hiccups with de-airing of the stomach as one of them. [ 5 ]…”