Treatment of intractable hiccups using combined cervical vagus nerve and phrenic nerve blocks under ultrasound guidance

Gong, Wen-Yi; Li, Na; Chen, Jun; Qi, Xiaoyuan; Fan, Kun

doi:10.23736/s0375-9393.21.15680-9

Cited by 6 publications

(7 citation statements)

References 4 publications

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“…If it is not well controlled, it will lead to some unexpected events and bring serious threats to the physical and mental health of patients [3,4]. Stroke is often accompanied by intermittent and recurrent hiccups sometimes followed by vomiting, reflux, aspiration, and other aggravating conditions which not only affect patients' sleep but also make them in a poor mood [7][8][9]. Stroke patients with dry heat, hyperactivity of liver-yang, qi stagnation and phlegm obstruction, and deficiency of liveryin and kidney-yin can cause the internal wind to multiply the lung and stomach, which results in gastric qi trapping on the phlegm and moving the diaphragm, thus causing hiccups [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Observation of Clinical Efficacy of Anisodamine and Chlorpromazine in the Treatment of Intractable Hiccup after Stroke

Wang

Zhu

Zhang

et al. 2022

BioMed Research International

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Objective. This study is aimed at investigating the clinical efficacy of anisodamine combined with chlorpromazine on intractable hiccups after stroke. Methods. 150 patients admitted to Affiliated Hospital of the Hebei University of Engineering from 2017 to 2021 were selected as the research objects, all of which received the computed tomography (CT) examination. During CT examination, intelligent algorithms were used to segment the images. An unsupervised multilayer image threshold segmentation algorithm was proposed by using Kullback-Leibler (K-L) divergence and the modified particle swarm optimization (MPSO) algorithm. All patients were divided into three groups, with each group of 50 patients. Patients in the control group (group A) took the calcium tablets, vitamin C tablets, and vitamin B1 tablets orally. Patients in the control group (group B) received the acupoint injection of anisodamine, and those in the observation group (group C) received the acupoint injection of anisodamine combined with chlorpromazine. The therapeutic effect and patient satisfaction of the three groups were compared. Results. The two-dimensional (2D) K-L divergence was applied for the multilayer segmentation of images, which was helpful to obtain accurate images. The MPSO algorithm was adopted to reduce the computational complexity. The total efficiency of group C was 98%, that of group B was 56%, and that of group A was 22%. The total efficiency and satisfaction rate of group C were signally better than those of group A and group B ( P < 0.05 ). Conclusion. The combination of 2D K-L divergence and MPSO algorithm could improve the accuracy of multilayer image segmentation and CT imaging. Acupoint injection of anisodamine combined with chlorpromazine had better efficacy than the injection of anisodamine alone for the treatment of intractable hiccups after stroke, with high safety and clinical promotion value.

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Section: Introductionmentioning

confidence: 99%

Observation of Clinical Efficacy of Anisodamine and Chlorpromazine in the Treatment of Intractable Hiccup after Stroke

Wang

Zhu

Zhang

et al. 2022

BioMed Research International

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“…[25] Furthermore, VN stimulation has been documented for the management of intractable hiccoughs (hiccups). [26] Additional uses for VN ultrasound include intraoperative neuromonitoring of thyroid surgery, radiofrequency ablation of thyroid nodules, and assessment of vocal cord paralysis. [27][28][29] However, there is significant variation in the currently published VN CSAs in the normal healthy population.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound of the normal vagus nerve cross-sectional area in the carotid sheath

et al. 2023

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The aim of this article is to utilize ultrasound to evaluate the normal cross-sectional area (CSA)of the vagus nerve (VN) in the carotid sheath. This study included 86 VNs in 43 healthy subjects (15 men, 28 women); mean age 42.1 years and mean body mass index 26.2 kg/m2. For each subject, the bilateral VNs were identified by US at the anterolateral neck within the common carotid sheaths. One radiologist obtained 3 separate CSA measurements for each of the bilateral VNs with complete transducer removal between each measurement. Additionally, for each participant, demographic information of age and gender as well as body mass index, weight, and height were documented. The mean CSA of the right VN in the carotid sheath was 2.1 and 1.9 mm2 for the left VN. The right VN CSA was significantly larger than the left VN (P < .012). No statistically significant correlation was noted in relation to height, weight, and age. We believe that the reference values for the normal CSA of the VN obtained in our study, could help in the sonographic evaluation of VN enlargement, as it relates to the diagnosis of various diseases affecting the VN.

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“…Hiccups (medically termed, "singultus") are often benign and self-limiting, but in rare cases they can be intractable and a sign of underlying pathology. Intractable singultus is de ned as hiccups persisting for > 1 month (1)(2)(3). This can result in signi cant and life-threatening medical consequences including insomnia, depression, malnutrition/anorexia, aspiration, pneumonia, and impaired wound healing (1,3,4).…”

Section: Introductionmentioning

confidence: 99%

“…Intractable singultus is de ned as hiccups persisting for > 1 month (1)(2)(3). This can result in signi cant and life-threatening medical consequences including insomnia, depression, malnutrition/anorexia, aspiration, pneumonia, and impaired wound healing (1,3,4).…”

Section: Introductionmentioning

confidence: 99%

Intractable hiccups after VNS implantation: A case report

Recio

Abdennadher

2023

Preprint

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Background Hiccups (medically termed, “singultus”), when intractable, can cause significant medical consequences such as aspiration, malnutrition, and depression, leading to poor quality of life. Several case reports have shown that vagus nerve stimulator (VNS) implantation can help treat central idiopathic intractable hiccups. However, we present a contrary case of a patient who developed intractable singultus following VNS placement for medically refractory epilepsy.Case presentation We report a 71-year-old male patient with drug-resistant epilepsy who underwent VNS implantation and developed intractable hiccups shortly thereafter. The hiccups were severe and persistent, such that the patient developed a Mallory-Weiss tear, requiring intensive care, invasive intubation and mechanical ventilation, and a prolonged rehabilitation course. Despite multiple therapies including phrenic nerve block and Nissen fundoplication, the patient’s hiccups persisted and only stopped once the VNS was permanently deactivated.Conclusions To the best knowledge of these authors, this is the first case of hiccups as a direct consequence of VNS implantation that has been reported in the literature. The clinical impact of this report is significant given the relative unfamiliarity of hiccups as an adverse effect of VNS implantation. Neurologists and epileptologists, who present VNS implantation as a surgical option for seizure control to their patients, should be aware of the possibility of singultus development and its significant physical and emotional ramifications.

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Treatment of intractable hiccups using combined cervical vagus nerve and phrenic nerve blocks under ultrasound guidance

Cited by 6 publications

References 4 publications

Observation of Clinical Efficacy of Anisodamine and Chlorpromazine in the Treatment of Intractable Hiccup after Stroke

Observation of Clinical Efficacy of Anisodamine and Chlorpromazine in the Treatment of Intractable Hiccup after Stroke

Ultrasound of the normal vagus nerve cross-sectional area in the carotid sheath

Intractable hiccups after VNS implantation: A case report

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