The annoyance of singultus: a case report of a rare adverse effect after epidural steroid injection.

Autor: Mena S; Department of Anesthesiology and Pain Management, Cleveland Clinic, 9500 Euclid Avenue, C25, Cleveland, OH, 44195, USA. MENAS3@ccf.org., Raj A; Department of Anesthesiology, Stony Brook University Renaissance School of Medicine, 101 Nicolls Road, Health Sciences Center, Level 4, Stony Brook, NY, 11794, USA., Caldwell W; Department of Anesthesiology, Stony Brook University Renaissance School of Medicine, 101 Nicolls Road, Health Sciences Center, Level 4, Stony Brook, NY, 11794, USA., Kaushal A; Department of Anesthesiology, Stony Brook University Renaissance School of Medicine, 101 Nicolls Road, Health Sciences Center, Level 4, Stony Brook, NY, 11794, USA.
Jazyk: angličtina
Zdroj: BMC anesthesiology [BMC Anesthesiol] 2024 Aug 31; Vol. 24 (1), pp. 302. Date of Electronic Publication: 2024 Aug 31.
DOI: 10.1186/s12871-024-02682-8
Abstrakt: Objective: Cervical epidural steroid injections (ESIs) can provide effective pain management for patients suffering from chronic neck pain due to various pathological changes of the cervical spine. There are several rare adverse effects reported from interventional pain procedures, including persistent hiccups ("singultus"). Based on a limited number of cases, we propose a modified treatment algorithm for this adverse outcome (Fig. 3).
Case Report: Singultus has been documented as an adverse effect of interventional pain procedures, including epidural steroid, facet joint, and sacroiliac joint injections. We describe the case of a general contractor who presented to our clinic with chronic neck pain and central canal stenosis. The patient received an uncomplicated lumbar ESI in the past and was recommended for a cervical interlaminar ESI. After an uneventful C6-C7 interlaminar ESI with dexamethasone, 1% lidocaine, and normal saline the patient developed singultus. Baclofen was sent to his pharmacy, but this was unsuccessful at alleviating his hiccups. The patient was subsequently started on chlorpromazine and found relief from his symptomatology.
Conclusion: Persistent hiccups after ESI or interventional pain procedures can be treated with conservative measures and non-pharmacologic methods, with escalation to therapy with baclofen, gabapentin, pregabalin, metoclopramide, chlorpromazine, other antipsychotic or antidopaminergic agents, and possible dual or triple therapy if further indicated.
(© 2024. The Author(s).)
Databáze: MEDLINE
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